For various privacy reasons, not just my own, I won't go into much detail to protect the innocent..... but I strongly felt this was worth sharing.... I met a prominent Haematologist (probably understatement) who is one the leaders in HSCT treatment in the UK, we spoke about HSCT obviously as well as alternative treatments. The conclusion after the discussion was the following with respect to alternatives to HSCT if you are PPMS........ Ocrevus has been around for a long time (20 yrs) in the form of Rituxan.... however the patent on Rituxan expires soon... so que Ocrevus.... in terms of efficacy, the view I received was little or no difference..... in essence this was a big pharma monetary spin.... I did google this and found out some interesting differences between the drugs, but in terms of efficacy, jury is out... I have to be honest, this was the first tangible time, I really felt sceptical about the pharma... hearing from this individual; its worth adding the respective conversation and opinions in no way served their own purposes, it was slightly out of context in fact..... Its worth pointing out, the conversation started out with the respective individual asking in a balanced manner, whether we had we done our R&D on Ocrevus vs HSCT and why we were not considering Ocrevus.... when cornered with the R&D we had conducted.... their view was more honest/transparent.... The message was if you are PPMS your choices are Ocrevus or HSCT ... its not even a comparison.... HSCT is really the choice, even when risks are considered..... Like all DMDs, they may delay the pattern or course of events..... but long term outcomes are always the same, SPMS in 16-18 yrs.... e.g. you might have no relapses for 1-12 yrs but when they come, it might be regular or like freight train, resulting the same long-term outcome... However HSCT, will halt for 3-8 yrs..... be your own judge, but know the facts and data.