HSCT For MS: Good or Bad? Effective or Not? Earlier, we posted about a British mom who underwent stem cell MS treatment in Mexico and whose condition improved after her treatment procedure. Specifically, her treatment is called haematopoietic stem-cell transplantation or HSCT.
It is also sometimes referred to as autologous haematopoietic stem-cell transplantation or AHSCT.
So what happens if a patient goes for an HSCT treatment? The MS Society (mssociety.org.uk) gives us some details on the process that he/she will undergo:
- Collection or ‘harvesting’ of stem cells from the bone marrow or blood of the person receiving treatment
- Freezing of the harvested stem cells until they are required. In some trials, the stem cells are purified before freezing.
- Administration of chemotherapy to wipe out an individual’s white blood cells
- Infusion of the thawed stem cells to help ‘reset’ the immune system
So is HSCT for MS effective or not? Well, we usually read anecdotal stories of people with MS who get well after their stem cell treatments. Now, we very well know that anecdotes do not a science make but there seems to be an emerging consensus in the medical community that HSCT for MS could and does work.
For instance, a literature review on HSCT for MS by Maha M. Bakhuraysah, Christopher Siatskas, and Steven Petratos arrived at the following conclusion: “HSCT is a plausible treatment paradigm for MS patients. However, auto-HSCT is considered to be a sledgehammer approach for treating MS patients, one that will be astoundingly effective when used on appropriately selected patients. The reasons for this promising therapy’s success are its lower toxicity and its ability to replace the immune system.”
The review adds: “The future of HSCT trials should discover novel therapeutic strategies that prevent ongoing neurodegeneration and demyelination in progressive MS. The trial designs should consider the reproducibility of HSCs with sufficient yield and purity, select MS patients with active inflammatory disease, and use appropriate conditioning agents.”
Meanwhile, Harold L. Atkins and Mark S. Freedman had this to say after looking at studies and reports on patients with MS who underwent HSCT treatments: “HSCT, when used to treat patients with aggressive highly active multiple sclerosis, can reduce or eliminate ongoing clinical relapses, halt further progression, and reduce the burden of disability in some patients, in the absence of chronic treatment with disease-modifying agents.”
The two believe that patients can benefit from HSCT: “When the overall worldwide experience is viewed together, HSCT appears most beneficial for patients with highly active MS who are progressing and who are refractory to conventional MS therapies. HSCT can be performed with acceptable treatment-related morbidity and little mortality. Selected subpopulations, such as those patients with malignant MS, may benefit even more substantially from HSCT.”
Want more proof that HSCT for MS could work? Well, here’s a specific study — published on the medical journal The Lancet — involving 24 patients which confirms that it does work (via eurekaalert):
A new use of chemotherapy followed by autologous haematopoietic stem cell transplantation (aHSCT) has fully halted clinical relapses and development of new brain lesions in 23 of 24 patients with multiple sclerosis (MS) for a prolonged period without the need for ongoing medication, according to a new phase 2 clinical trial, published in The Lancet. Eight of the 23 patients had a sustained improvement in their disability 7.5 years after treatment. This is the first treatment to produce this level of disease control or neurological recovery from MS, but treatment related risks limit its widespread use.
However, it is worth noting that one of the patients who underwent HSCT for MS treatments died “from hepatic necrosis and sepsis caused by the chemotherapy.”
A few years down the road, we hope there will be a clearer picture on how HSCT can best benefit people with MS.
HSCT For MS: Effective or Not? Good or Bad? Posted 28 December 2016.