PROTOCOL COMPARISON

I understand it may sound strange, but paperwork has become much easier with the advent of a 90-day tourist visa. Visa application package, including advanced travel insurance with full coverage of treatment in case of covid infection, is sent along with a step-by-step guide to filling out the online application and in 3-10 days the visa is ready. Processing goes very smooth and easy due to the low workload of the consular offices. Most often, the patient does not even have to leave the house to get a visa and are able to manage it by post.

Unfortunately, there is no direct flights to Moscow, so patients have to take flight tickets with connection in Istanbul, Belgrade or Dubai. The number of flights between these countries has been significantly increased, so it's not a challenge to get the tickets.

Treatment in Mexico can be compared to Moscow, mainly in terms of the cost. In all other respects, we should not put them in the same row, It's a bit unfair, it's like to compare a wellness hotel and a university multidisciplinary hospital. Clinica Ruiz is more of a commercial project, and because of this, of course, it has a number of advantages in terms of comfort of accommodation and other services. In terms of safety and effectiveness, Mexico is certainly not comparable to University Hospitals such as Northwestern University in Chicago, Heidelberg University Hospital in Germany, Careggi University Hospital in Italy, as well as National Medical Surgical Center.

University Hospitals are licensed and funded by the government and have unparalleled scientific and technical capabilities to carry out assigned tasks with maximum efficiency and safety, meantime conducting continuous scientific activities to develop, optimize and implement high requirements for ensuring the quality of treatment and patient safety.

Let's start with the main goals of this quite expensive method of treatment:

1. Complete elimination of the defective immune system, the main cause of the disease.

2. Launching a new immune system, absolutely without any traces of the disease.

To achieve the first goal, we need a high-dose chemotherapy and what is more important, effective and safe applying of this chemotherapy.

Otherwise, this treatment has no difference from traditional therapy, where you're unable to get rid of the disease and have to continue taking pills forever.

At first glance, the both protocols look the same, total load of Cyclophosphamide also the same, but the main difference is in applying chemo:

Our conditioning regimen suggests 50 mg. per kg. weight continuously for a 4-day course, and what is the most important: without interruptions!

The conditioning regimen in Mexico is different, the first injection of Cyclophosphamide 100 (mg per kg of body weight), and then you have a break for a whole week until the second injection.

The fact is that after a single intravenous administration, the content of Cyclophosphamide in the blood plasma tends to rapidly decrease during the first 24 hours.

Studies show that after 72 hours it is still possible to detect their content in the blood, but this amount becomes negligible.

The fact is that after a single intravenous injection, the content of Cyclophosphamide in the blood plasma tends to decrease rapidly during the first 24 hours.

Studies show that it is still possible to detect their content in the blood plasma after 72 hours, but this amount becomes negligible.

Consequently, after the first administration of Cyclophosphamide, the pharmacological effect does not have time to develop, and over the course of a week (168 hours), all Cyclophosphamide is safely eliminated from the body.

Only 4 days of continuous immunosuppression leads to neutropenia. In this state, you simply have no chances to survive outside the aseptic unit.

The «Mexican method» conditioning regime is more a formality, they split the chemo into two batches of two sessions one week apart. After each session you are able to return to the hotel or go sightseeing.

Therefore, people planning HSCT in Mexico should realize, that carried procedure can partially reduce the disease, but definitely can't eliminate it. It is important!

Those who did not realize that, after several years of observing negative dynamics, comes to us in order to perform a real HSCT (HDIT with AHSCT), in accordance with the original protocol.

Accreditation means that the clinic meets the requirements of the Ministry of Health. In terms of requirements for the premises, equipment of the clinic, staff qualifications.
A clinic thinking about performing CM transplants receives an accreditation/license from its Ministry of Health. Serious work with cellular technologies, in particular with stem cells throughout the world, is the prerogative of the government in view of the complexity of the processes and the requirements for personnel qualification.

I will not write much about the Indian protocol, everything is obvious here, this is an extremely dangerous practice based on the very first steps in this area.
Especially considering that Artemis protocol using Antithymocyte Globulin (rATG) according to the published studies of Dr. Fedorenko and Dr. Burt - it causes allergic reactions in 30% of patients (in most cases severe up to shock). And every such patient had a relapse of MS within a year after AHSCT.

It is unlikely that the Ministry of Health of one country in such an important issue of protecting the health of citizens will accept the requirements of another country. Due to the difference in staff training, difference in climate, difference in treatment approaches, experience gained, etc.

The clinic, which flaunts the accreditation of another Ministry of Health, thus admits that the medicine of our country is so bad that we have received accreditation from another country for patients to somehow correct this shortcoming. Although she does not give us anything. But we got. It also allows us to compensate for the lack of presence in the international scientific school by the presence of a loud slogan. "We are accredited to JCI-USA.". In the true scientific community, the accepted formats of interaction with authoritative specialists are training for the formation of qualified personnel, joint work to reach new heights. But not worship to mislead patients.

In the case when the manipulations performed do not fall under the term treatment, accreditation is not needed. In this case, the presence of foreign accreditation gives the illusion that this institution provides treatment according to American standards. In reality, however: in rooms that meet the requirements of the American Association, manipulations are carried out that imitate the AHSCT process. In order not to fall under the regulation of India, Mexico and not be liable. But so that patients have the feeling that they are being treated according to the most advanced standards.

JCI is the most established company in the US market of international accreditation systems for medical organizations
The purpose of the JCI standards is to create security mechanisms.
Its standards make it possible to create safe conditions for the provision of medical care, to determine quantitative indicators of the quality and safety of processes in an organization, and to expand the possibilities for improving the level of competence of medical workers.
The standards are based on the prevention of the risks of infections associated with the provision of medical care, the correct identification of the patient's identity, the safety of the use of medicines and medical devices, the implementation of pain relief measures, as well as the prevention of systemic and most common slips in medical activities. For example, so that the surgeon does not amputate the wrong limb to the patient by mistake.
The presence of such accreditation is especially useful for commercial clinics, the presence of a single standard inspires confidence among patients from different parts of the world, which contributes to the export of medical services.

Accreditation is a local standard that confirms that the hospital has the necessary equipment and staff. Russia has very strict regulation and accreditation by the Ministry of Health.

Transplantation can only be carried out by state university centers. If some hospitals have European or American accreditation, this does not mean that they provide the best treatment.

All transplant research believes that centers that treat autoimmune diseases should have experience and experienced staff in this area. Accreditation alone is not enough to ensure safe treatment. All centers must be accredited in accordance with local government regulations, and we have it. Accreditation ensures that we have a department, equipment, personnel and we comply with Russian rules and safety standards. But long-term experience is much more important - the opinion of patients, the opinion and recognition of other specialists, statistics, conferences and scientific articles. The most significant indicator in transplantation is a membership of the Pirogov Center in the EBMT medical and scientific organization.

In accordance with the development of this direction. The higher the scientific and empirical experience, the development of progress in general, the higher and fuller the requirements. Incl. and treatment protocol.

In the Russian Federation, at the legislative level, strict requirements have been established for the organization and conduct of internal quality control and safety of medical activities, which is especially well implemented in state medical institutions.

All Federal Government Budget Institutions are supervised by many higher regulatory authorities, such as the Ministry of Health, Federal Department for Control in Healthcare,

Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Department of Health of the City of Moscow.

Moreover, in Russia, for more than a century, there have been entire national quality institutes that conduct continuous scientific activities to develop, optimize and implement high requirements for ensuring the quality of treatment and patient safety.

The Pirogov Center is one of the flagships of the Russian advanced medicine, a benchmark in the provision of quality medical services based on the use of modern high-tech methods of diagnosis, treatment, rehabilitation and prevention.

These are research, continuous experience, educational programs, preparation of a scientific school. Our University Hospital is a member of the scientific EBMT, regularly publishes in specialized authoritative publications, holds and participates in international conferences.

Yes, during the 16 years of practice, in total was performed about 3,000 of various transplantations in a single department, including about 2000 foreign patients.
Currently we are the one of the largest single center experience, practical experience in the world.
You can find this information on the Internet; the most recent ones are published on our website, for example:

New Lymphoablative Conditioning Regime for Relapsing-Remitting Multiple Sclerosis (RRMS)

Clinical Studies - low-Intensity conditioning regimens in RRMS

Clinical and Patient-Reported Outcomes of HSCT (Mainly focused on SPMS, RRMS)