Guidelines for autologous blood and marrow stem cell transplantation in multiple sclerosis: a consensus report written on behalf of the European Group for Blood and Marrow Transplantation and the European Charcot Foundation

Recent reports suggest the possible beneficial effects of haemopoietic stem cell transplantation (HSCT) in autoimmune diseases such as multiple sclero sis (MS). The definition of the risk/benefit ratio for such a treatment is perceived as a major issue for the neurological community worldwide. The Fi rst Consensus Conference on Bone Marrow Transplantation in Patients with Mu ltiple Sclerosis was held in Milan, Italy on 21 February 1998. Participants from 16 European, North American, and South American countries discussed t he guidelines for performing HSCT in MS. This conference was organized in o rder to: (a) define criteria for patient selection; (b) define transplantat ion procedures to maximize efficacy of the treatment and minimize its toxic ity; (c) standardize patient outcome evaluation; and (d) establish an inter national working group to evaluate the efficacy and safety of HSCT in MS an d to study the immunological changes related to HSCT in MS patients. During the meeting in Milan agreement was reached on: (a) the preparation and dis tribution of a consensus report on HSCT in MS and (b) the design of an open trial for an initial assessment of the safety and efficacy of HSCT in MS. The consensus reached during the meeting and the design of the clinical tri al are summarized in this contribution.