Questions
Q1: I am a 35-year-old woman who was diagnosed with RRMS in 2019. I worked in applied mathematics and computer science but switched to a less cognitively demanding job two years ago because of cognitive fatigue. I plan to have AHSCT in less than two months, but some questions still make me hesitant.
Will HSCT improve my prognosis compared with my current treatment (Ocrelizumab + alpha lipoic acid)? I have been stable on Ocrelizumab for almost two years.
I have no access to Alemtuzumab here because of a stable MRI. My neurologist tells me that my MS is very light because I have a low lesion load and no brain atrophy and that my risk for progressing under ocrelizumab is almost negligible.
Does AHSCT have a chance to change the course of my cognitive trajectory? My neurologist tells me that it is not possible to have MS-induced cognitive difficulties so early in the disease course without brain atrophy. Do you agree?
Does a family history of auto-immunity increase the risks of developing a secondary auto-immune disease after AHSCT?
I am wondering if I have smouldering MS? Spinal fluid neurofilament testing is unavailable here. Do you think blood neurofilament testing is sufficient?
Thank you.
Q2: Do you have any info regarding alemtuzumab (Lemtrada) and HRT regarding cancer risk? I feel I need HRT, but I am concerned that because of the risk of cancer, I should not take HRT.
NOTE: General substack newsletters and microsite are free; it is only Q&A sessions that are restricted to paying subscribers. I can't run and maintain the MS-Selfie microsite, hence the need to pay people to help do the work for me. If people want to ask medical questions unrelated to the Newsletters or Podcasts, they either need to become paying subscribers or email (ms-selfie@giovannoni.net) to request a complimentary subscription.
Answers
Listen to this episode with a 7-day free trial
Subscribe to MS-Selfie to listen to this post and get 7 days of free access to the full post archives.
