Multiple Sclerosis Stem Cell Treatment: FAQ

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Jan. 19, 2016 -- Multiple sclerosis experts are welcoming a groundbreaking treatment that shows promise for some people with the disease. It uses harvested stem cells to reset patients’ immune systems and reverse some of the symptoms of MS.

An update on the treatment, developed at Sheffield Teaching Hospitals in the United Kingdom, was recently featured in a British television program. Cameras followed four people with the relapsing-remitting form of the disease as they got treated.

The treatment is called an autologous hematopoietic stem cell transplant (AHSCT, sometimes also shortened to HSCT). In the United States, two hospitals in Chicago and Seattle offer it, according to The Immune Renewal Foundation.

But MS charities say stem cell therapy isn't right for all people with the condition.

Here are some questions and answers about the new the treatment and how it could help.

How Does the New Treatment Work?

The goal of AHSCT is to reset your immune system to stop it from attacking nerve cells in your body. It’s used for other conditions as well, including lupus, rheumatoid arthritis, and type 1 diabetes.

During the treatment, doctors collect bone marrow stem cells from your blood and freeze them. These "haematopoietic stem cells" are at such an early stage of development that they haven't acquired the flaws that trigger MS.

Your faulty immune system is then destroyed using chemotherapy. The thawed-out stem cells are re-infused into your blood to reboot your immune system.

"The immune system is being reset or rebooted back to a time point before it caused MS," says John Snowden, MD, consultant hematologist at the Royal Hallamshire Hospital in Sheffield, U.K.

What does the latest research say?

The most recent study showed that in 123 people with relapsing-remitting multiple sclerosis, AHSCT was linked to a 64% reduction in disability on average.

Eighty percent of the people treated who were followed for 4 years had no more relapses, and 87% had no worsening of their level of disability.

In Sheffield, around 20 patients have so far been treated at the Royal Hallamshire Hospital.

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How Successful Are the Sheffield Trials?

“The new treatment is showing some remarkable results in the small number of patients we have treated so far," Basil Sharrack, consultant neurologist at Sheffield Teaching Hospitals' NHS Foundation Trust, says in a statement.

“It is important to stress, however, that this treatment is unfortunately not suitable for everyone. The treatment is only suitable for patients with relapsing-remitting multiple sclerosis disease who have had 2 or more significant relapses in the previous 12 months, failed to respond to standard drug treatment, and who have had the illness for no more than 10 years.”

Royal Hallamshire Hospital cites the case of one of its patients, Holly Drewry, whose MS had reached the point where she was unable to walk to local shops.

Following stem cell treatment, Drewry is quoted by the hospital as saying: "It's been amazing. I got my life and my independence back and the future is bright again.”

The hospital says that 2 years after treatment, Drewry has had no relapses, and there is no evidence of active disease on her scans.

What Are the Risks?

AHSCT is a very strong treatment. You'll get chemotherapy as part of it.

It's rare, but side effects can be severe and you may need to be hospitalized for them.

Staff at Sheffield Teaching Hospitals tell patients that the procedure may lead to potentially life-threatening complications.

But the hospital points out that none of its patients being treated specifically for MS have died.

What Do Other Experts Think?

“Ongoing research suggests stem cell treatments such as HSCT could offer hope, and it’s clear that in the cases (featured on the British TV program) they’ve had a life-changing impact,” says Emma Gray, head of clinical trials at the MS Society in the U.K.

“However, trials have found that while HSCT may be able to stabilize or improve disability in some people with MS, it may not be effective for all types of the condition. We want people to be aware that HSCT is an aggressive treatment that comes with significant risks. It needs to be carried out at an accredited center or as part of a clinical trial.

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“The MS Society has recently funded a study looking into the impact of HSCT on the immune system, and we’d like to see larger trials in this area. They would help us learn more about the safety and long-term effectiveness of the treatment and who could benefit from it.”

Amy Bowen, director of service development for the MS Trust in the U.K., cautions: “As the program made clear, stem cell therapy is still very experimental, and is not suitable for everyone. However, it could be a potentially very effective therapy, holding great promise for people living with MS.

“It’s also a long way from being a routine treatment for MS." She says more clinical trials need to be done to understand who's most likely to benefit from AHSCT, to create safer treatment procedures, and to know what the long-term effects might be.

The trust is announcing that it will work with a group of other experts to do an audit into stem cell therapy to help understand how people with MS can be assessed and selected for treatment.

WebMD Health News Reviewed by Hansa D. Bhargava, MD on January 19, 2016

Sources

SOURCES:

Sheffield Teaching Hospitals NHS Foundation Trust.

Burt, R.K. JAMA, Jan. 20, 2015.

MS Society.

MS Trust.

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