Stem cell transplant shows promise in aggressive multiple sclerosis--study

MS is an inflammatory disease that damages the myelin sheath that protects the nerve fibers of the central nervous system.

It can lead to problems in vision, muscle weakness, and decline in thinking and memory. The natural process by which lost myelin is rebuilt and replaced is blocked in people suffering from this devastating disease.

Scientists from Greece have shown that chemotherapy followed by the treatment called hematopoietic stem cell transplantation (HSCT) can stop progression of aggressive MS.

HSCT involves destroying the patients' immune and other blood cells that were attacking their nervous system and then replacing it with their own bone marrow adult stem cells.

Experimental HSCT administered to 35 patients with MS
The investigators enrolled a group of 35 patients suffering from aggressive multiple sclerosis. The study subjects scored a six on the multiple sclerosis severity scale.

(A zero means normal neurological function while 10 indicates death. A six means the person can walk with a cane or crutches and a seven means the person must use a wheelchair.)

They had tried various treatments, like steroids, interferon-beta, and azathioprine for the disease but found no relief.

The scientists administered the experimental stem cell transplant to a group for MS. As a part of the treatment regimen their dysfunctional immune and blood cells were destroyed with high doses of chemotherapy drugs and then replaced with healthy stem cells.

Outcome of the study
The patients were then tracked for a period of 11 years. It was noted that 25 percent of the patients did not see a worsening of their disease.

Among patients in the inflammatory phase of the disease with active lesions before their transplants 44 percent did not experience any further progression of MS.

In addition, 16 people exhibited an improvement on their disability scale by an average of one point after the transplant which lasted for an average of two years.

Moreover, the study subjects also had a reduction in the number and size of lesions in their brains.

However, two patients died, at two months and 2.5 years, from transplant-related complications, one of aspergillosis, one of pulmonary hemorrhage.

Lead author of the study, Dr Vasilios Kimiskidis of Aristotle University of Thessaloniki Medical School in Greece stated, “Keeping that in mind, our feeling is that stem cell transplants may benefit people with rapidly progressive MS.

"This is not a therapy for the general population of people with MS but should be reserved for aggressive cases that are still in the inflammatory phase of the disease.”

The study is published in the March 22, 2011, print issue of 'Neurology.'