BMI doesn’t affect response to stem cell transplant for MS
Treatment can be effective regardless of BMI, study finds
Body mass index (BMI), a measure commonly used measure of body fat based on a person’s height and weight, does not seem to affect responses to stem cell transplant in people with multiple sclerosis (MS), a study found.
While the efficacy of an autologous transplant — one that uses a patient’s own stem cells — appears to be independent of BMI, “further studies are needed to explore the broader implications of BMI on treatment outcomes,” the researchers wrote.
The study, “Body mass index is unrelated to the response to autologous hematopoietic stem cell transplantation in persons with multiple sclerosis,” was published in the Journal of Multiple Sclerosis and Related Disorders.
In MS, the immune system mistakenly attacks the protective coating around nerve cells, causing damage in the brain and spinal cord. As the disease progresses, MS symptoms such as problems with movement, vision, and other body functions worsen.
BMI has gained attention as a possible factor that may affect MS progression or responses to treatment. It’s a simple measure commonly used to classify people as underweight, normal weight, overweight, or obese.
BMI linked to neurodegenerative conditions
“While BMI has been linked to other neurodegenerative conditions, its specific impact on MS remains unclear,” the researchers wrote.
For their study, they focused on whether BMI affected how well patients responded to an autologous hematopoietic stem cell transplant (aHSCT).
This type of stem cell transplant is sometimes used in MS, especially when other treatments haven’t worked. Doctors start by collecting a patient’s own stem cells from blood, then use chemotherapy to wipe out most of the patient’s immune cells. After that, the stem cells are returned to the body to help rebuild the immune system with cells that are not primed to attack the nervous system.
The study involved 457 patients who received aHSCT at the Centro de Hematología y Medicina Interna de Puebla in Mexico, and completed follow-up evaluations three months and 12 months after the procedure.
Of them, 98 had primary progressive MS, 144 had secondary progressive MS, and 215 had relapsing-remitting MS. Based on their BMI, 16 patients were underweight, 227 were normal weight, 138 were overweight, and 76 were obese.
The researchers used the Expanded Disability Status Scale (EDSS) to track changes in disability from MS. EDSS scores range from 0 (no disability) to 10 (death due to MS). A positive response was defined as an EDSS score that stayed the same or decreased after the transplant.
Results showed that the median EDSS score decreased significantly, from 5.5 points to 5 points, with most patients (77%) showing a positive response to the aHSCT.
When BMI groups were examined separately, positive responses were observed in 100% of underweight patients, 75% of those with normal weight or who were overweight, and 74% of obese patients. There were no significant differences among the groups.
“The results highlight that aHSCT can be effective regardless of BMI,” the researchers concluded. All patients, regardless of BMI group, showed similar improvements.
Yet “several variables need to be considered, such as diet, place of origin, physical activity, and serum nutrient levels,” they wrote. “This paves the way for future research.”
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