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Autologous hematopoietic stem cell transplantation (aHSCT) is a cell-based immunotherapy being investigated as a treatment for highly active relapsing-remitting multiple sclerosis (RRMS). The procedure involves mobilizing and harvesting a patient's own hematopoietic stem cells, followed by a conditioning regimen—specifically a low-intensity, non-ablative protocol using cyclophosphamide and anti-thymocyte globulin (ATG) in the RAM-MS trial—to deplete the existing autoreactive immune system. The harvested stem cells are then reinfused intravenously to reconstitute a new, potentially self-tolerant immune system. This immune reset aims to halt the inflammatory attack on the central nervous system and provide long-term remission without the need for continuous disease-modifying therapies.
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