Ocrelizumab or Alemtuzumab Compared With Autologous Hematopoietic Stem Cell Transplantation in Multiple Sclerosis - a Phase-2 Randomised Controlled Trial

Inclusion Criteria (Based on CARE-MS-II3, guidelines and Rio-criteria for treatment failure): * Written informed consent and agreement to comply to study protocol * Age: 18-55 years * EDSS: 0.0 - 6.0 * RRMS according to McDonald 2010 * \< 10 years of disease course after symptom onset * Active disease with one of the following treatment failures occur-ring not earlier than 6 months after initiation of an approved DMT * 2 or more relapses within the last 12 months or * 1 relapse within the last 12 months and a Gd-enhancing lesion on MRI \> 3 mm \> 3 months before or after relapse onset or 2 new T2-lesions or * On-going signs of MRI activity in the last 6 months (either Gd-en-hancing of ≥ 3 mm lesion at any exam in the last year; or more than 5 new T2 lesions (≥ 3 mm) or * Patients stable under natalizumab but who have to stop treatment due to an increasing PML risk are defined as active, if a MRI within 6 months after termination of natalizumab shows new T2 or Gd-enhancing lesions and at least one other treatment fail-ure prior to natalizumab is documented. Exclusion Criteria: * Secondary or primary progressive MS * Pregnancy, or other medical condition incompatible with aHSCT * Any treatment or medical condition that, according to the haematologist / transplant specialist precludes the use of aHSCT * John Cunningham virus (JCV) antibody index of \> 1.5 in previ-ously natalizumab-treated patients, if a negative CSF JCV-PCR prior to screening is not available * Relapse during 30 days before initiation of treatment. If a relapse occurs during this period and eligibility criteria are otherwise ful-filled, start of treatment will be delayed until at least 30 days after receiving steroids. * Concurrent clinically significant (as determined by the investiga-tors and haematologist / transplant specialist) cardiac, immuno-logical, pulmonary, neurological, renal or other major disease such as: * Prominent cardial disease (Left ventricular ejection frac-tion (LVEF) \< 40%, myocardial infarction or ischemia, un-controlled arrhythmias, pericardial effusion \> 1 cm) * Cerebrovascular disease * Renal disease (creatinine clearance \< 30 ml/min/m2) * Respiratory disease (DLCO \< 40% predicted) * Active bleeding or clotting disease * History of human immunodeficiency virus (HIV) or posi-tive HIV antibody testing * Any uncontrolled acute or chronic infection, including HIV, hepatitis B surface antigen positivity and hepatitis C PCR positivity * Cancer except in situ cervix or cutaneous * Unwillingness or inability to comply with the requirements of this protocol including the presence of any condition (physical, men-tal, or social) that is likely to affect the patient returning for follow-up visits on schedule. Unwillingness to use contraception. * Previous participation in this study, previous treatment with aHSCT or already both comparators * Ongoing immunotherapy. Treatment with interferon or glati-rameracetate will need no wash-out. Treatment pause before oc-relizumab/alemtuzumab or aHSCT will be: * for dimethylfumarate and fingolimod: 8 weeks * for natalizumab: 8 weeks * for ocrelizumab: 12 weeks * for alemtuzumab: 12 months * for teriflunomide: 4 weeks after elimination with cholesty-ramine * for cladribine: 24 weeks * Patients with cognitive impairments who are unable to provide written, informed consent prior to any testing under this protocol, including screening and baseline investigations that are not con-sidered part of routine patient care.