WEEK 1 WEEK 2 WEEK 3 WEEK 4

The “Mexican Method” as performed by Clínica RuízNon-Myeloablative HSCT for MS & Autoimmune Disease

Dr. GJ Ruíz-Argüelles

THE“MEXICANMETHOD”

MEDICALPRE-TESTING

3

CHEMOTHERAPY

DAY – 2 &DAY – 1

NEUTROPENICRECOVERY

BeginsDAY +1

NEUTROPENICRECOVERY

CHEMOTHERAPY

DAY – 11 &DAY – 10

STEM CELLHARVEST

DAY –2

STEM CELLTRANSPLANT

DAY ZERO

5 6 7 8 94

2Two days of cyclophosphamide chemo-therapy to condition the immune system– begin to kill white blood cells and mobilize new stem cells.

4Apheresis. Patient’s own adult stem cells are filtered out of the blood by a centrifuge and stored at four degrees celcius.

6Day Zero. Stem cells are given back to the patient to speed up recovery.

8White blood cells return to safer levels, but cautionary diet and exposure persist.

9To minimize the chance of a post-procedural relapse, a rituximab infusion is given to deplete any remaining CD20 B-cells. Some people report noticable reversal of MS symptoms by this point. Patient is safe enough to return home.

1Extensive medical tests include review of patient MRIs (brain plus cervical, thoracic & lumbar spine), chest X-ray, blood panel, electrocardiogram, spi-rometry. Consultation with neurologist, cardiologist & hematologist. Medical history.

3Subcutaneous injections twice daily to mobilize the stem cells from the bone marrow into the blood. Outpatient surgery to install a hemodialysis catheter.

5Two days of high-dose cyclophospha-mide chemotherapy to destroy the majority of the existing immune system. This is the most crucial part of HSCT; everythig else supports this step.

7During neutropenia, white blood cell count is abnormally low and suscepti-bility to infection is high. Diet and exposure are highly controlled. Stem cells grow into new immune cells without memory of MS. Additional growth factors are given to encourage additional new stem cells. Blood samples every 48 hours. Lots of prophylactic medication.

21APPROXIMATELY

ONE YEAR TO FULL RECOVERY, TWO YEARS TO FULL

BENEFIT

Num

ber o

f Im

mun

e C

ells

Normal

None

NadirAt nadir, the immune system, and thus the autoimmune disease, is depleted.

Neutropenic

STEM CELLMOBILIZATION

DAY –9

RITUXIMABINFUSION

Source: A. Arthur Fisher, www.incolor.net6/2016, Version 10

NOTE: this chart is my interpretation of the procedure. Timeline is approximate, different for each group and each individual.