• Evaluate baseline, treatment regimen and outcomes of patients who self referred for AHSCT.
• Evaluate clinical baseline and outcomes of patients who were referred for AHSCT as per local protocol, and those who self-referred for treatment privately.

Recent research has demonstrated that AHSCT is a highly effective therapy for multiple sclerosis, particularly in those with active disease. Mortality and morbidity have reduced significantly over the past 13 years.  Local protocol limits referral for treatment to patients with active disease, a disease duration less than 15 years and requires failure of a highly active therapy.  Patients who do not meet these criteria are increasingly self-referring to centers internationally, raising both medical and ethical concerns. 

Clinical records of 14 patients attending St Vincent’s Hospital MS clinic and who had received stem cell treatment were reviewed. Baseline demographic details including EDSS and MRI were obtained.

Information on treatment received was obtained from discharge letters provided by treating centers.  Patients who self referred for treatment internationally remained under our care for ongoing follow up. 

7 patients were referred for stem cell treatment as per local protocol. 7 patients self-referred and self-funded treatment.  Baseline EDSS and MRI are available for 12/14 patients. Details on treatment received and conditioning regimes are available for 11 patients.  One-year follow up data is available for 7 patients. Between group differences will be discussed. Data on early and late post-procedure complications was reviewed. 

Self-referral for stem cell treatment has increased in a cohort of patients with multiple sclerosis. Data collection on treatment regimen and outcome on this group of patients is limited. Audit of outcomes in all patients who receive stem cell treatment can inform the clear knowledge gap in this area.