Where Stem Cell Transplant Fits in the Modern Multiple Sclerosis Treatment Landscape: Jeffrey Cohen, MD

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“We now have multiple randomized trials that will directly compare hematopoietic stem cell transplantation against our most effective disease-modifying therapies. That’s a critical step, because it moves transplant from anecdote and observational data into true evidence-based positioning within the MS treatment algorithm.”

Over the past decade, hematopoietic stem cell transplantation and other cell-based therapies have moved from the margins of multiple sclerosis (MS) research into the center of high-level scientific debate. As high-efficacy disease-modifying therapies have reshaped inflammatory control in relapsing MS, attention has increasingly turned to whether more aggressive immune reconstitution strategies can deliver deeper, more durable remission. At the same time, parallel efforts are exploring whether stem cell–based and pharmacologic approaches might one day promote repair in progressive disease, an area of persistent unmet need.

At the Americas Committee for Treatment & Research in Multiple Sclerosis (ACTRIMS) Forum 2026, held February 5-7, 2026, in San Diego, California Jeffrey Cohen, MD, delivered the welcome and Kenneth P. Johnson Memorial Lecture, focusing on hematopoietic stem cell transplantation (HSCT) and the evolving pipeline of cellular therapies in MS. Cohen, professor of neurology at Cleveland Clinic and holder of the Hazel Prior Hostetler Endowed Chair, outlined ongoing randomized trials comparing HSCT against high-efficacy disease-modifying therapies in patients with active relapsing MS and moderate disability. He also reviewed emerging strategies such as CAR T-cell approaches and investigational repair-focused stem cell platforms.

Following the meeting, Cohen sat down with NeurologyLive^® to expand on where the field stands today. In the discussion, he detailed the rationale behind immune “reset” strategies, explained how current transplant trials are designed, and outlined how CAR T cells and mesenchymal stem cell programs differ in their therapeutic goals. He also addressed the challenges facing remyelination strategies and what clinicians should realistically expect from the next phase of development.

Click here for more ACTRIMS Forum 2026 coverage.