Stem Cell Treatment For MS Patients Improves Their Immune System And Extends Remission
Multiple sclerosis (MS) is a disease that triggers the immune system to attack the myelin covering nerves, and damages the central nervous system over time. While it affects everyone differently — leaving some wheelchair-bound and others not so disabled — there is no cure for the disorder.
But stem cell transplants might soon offer MS patients an effective way to stave off relapses and improve their overall neurologic condition. Three years ago, a number of patients suffering from multiple sclerosis (MS) were given high-dose immunosuppressive therapy (HDIT) and then transplanted with their own hematopoietic stem cells in a study called Transplantation for Relapsing-Remitting Multiple Sclerosis (HALT-MS). In a new report released this week, researchers declared a moment of victory: most of the MS patients treated in the study have been in remission of active relapsing-remitting MS (RRMS) — and have seen improvements — since this treatment.
Using a therapy called autologous hematopoietic cell transplant (HCT), which uses a patient’s very own cells, the researchers were able to reset the immune system in a way, paving the way for extended remission and improvements in people’s neurologic function. Of the 24 patients who received HCT or another treatment known as high-dose immunosuppressive therapy (HDIT), progression-free survival had a rate of 90.9 percent, while clinical relapse-free survival was at 86.3 percent.
“In the present study, HDIT/HCT induced remission of MS disease activity up to three years in most participants,” the authors write in their conclusion. “It may therefore represent a potential therapeutic option for patients with MS in whom conventional immunotherapy fails, as well as for other severe immune-mediated diseases of the central nervous system.”
Known as RRMS, relapsing-remitting MS involves consistent flare-ups or relapses of the disorder followed by partial recovery periods. Each time there’s a relapse, it appears to bring with it worse neurologic function — even if the following “recovery” period involves no symptoms. Inflammatory attacks on myelin, which are the membrane layers around nerve fibers in the central nervous system, create small damaged areas which in turn produce MS symptoms. RRMS is different than progressive MS, however, in that people with RRMS have more brain lesions with more inflammatory cells. People with primary-progressive MS (PPMS), meanwhile, have more spinal cord lesions with fewer inflammatory cells — and their disease is progressive, meaning it’s gradual but steady, with no stops and starts like RRMS.
“These promising results support the need for future studies to further evaluate the benefits and risks of HDIT/HCT and directly compare this treatment strategy to current MS therapies,” NIAID Director Anthony Fauci said in a NIH news release. “If the findings from this study are confirmed, HDIT/HCT may become a potential therapeutic option for people with this often-debilitating disease, particularly those who have not been helped by standard treatments."
Nash R, Hutton G, Racke M, Popat U, Devine S, Griffith L. "High-Dose Immunosuppressive Therapy and Autologous Hematopoietic Cell Transplantation for Relapsing-Remitting Multiple Sclerosis (HALT-MS)." JAMA Neurology, 2014.