MONDAY, March 21 (HealthDay News) -- Stem cell transplants may
hold some hope for patients with rapidly progressing multiple
sclerosis, the authors of a long-term study report.
The controversial treatment, known as hematopoietic stem cell
transplantation (HSCT), involves ablating, or removing, the
patients' immune and other blood cells, then replacing it with new
bone marrow stem cells from the same patient.
The idea is to "reset the thermostat and start fresh," said Dr.
Aaron Miller, chief medical officer for the National Multiple
Sclerosis Society and a professor of neurology at Mount Sinai
School of Medicine in New York City.
But Miller, who was not involved in the study, doubts the
procedure will become a viable option for patients with aggressive
"This is a very heroic form of therapy for multiple sclerosis [MS], which is unlikely, in my view, ever to have a major impact on the field," added Miller. "It's a substantially risky therapy -- the mortality rates have been in the 2-3 percent range . . . and it's hugely expensive."
MS is a disease of the nervous system. There is no known cause
or cure, and in severe cases patients may be unable to write, speak
This study, published in the March 22 issue of
Neurology, was begun 15 years ago. Back then, "perhaps we didn't have other good alternatives for aggressive disease," he said. "I think we now have better and safer alternatives."
Those alternatives include the biologic therapies Tysabri
(natalizumab) and Gilenya (fingolimod), approved in 2006 and 2010,
respectively. But Miller emphasized these can only be considered
"potentially" more effective than HSCT because the two have never
been tested head-to-head.
The trial organizers reported earlier that 80 percent of
patients receiving HSCT treatment had stabilized disease after five
years. They also noted positive brain changes on an MRI.
Now, after 15 years, the authors report that overall 25 percent
of the 35 initial patients are stabilized. The success rate was
better -- 44 percent -- for those with active brain lesions,
signaling aggressive disease, they found.
Many had a lessening of their disability, and fewer and smaller
lesions in the brain.
But two participants, or 6 percent, died of complications from
Research on this aggressive therapy is continuing, say the
authors, from Aristotle University of Thessaloniki Medical School
But more information might be hard to come by because the
treatment's high mortality rate makes it difficult to recruit
Still, they said, HSCT might be a "salvage" therapy for
"It's a possible treatment strategy, but it remains to be seen how much of a treatment option it is," said Dr. Mark Keegan, associate professor of neurology at the Mayo Clinic in Rochester, Minn.
"We do need ways to treat people with aggressive MS," he added.
National Multiple Sclerosis Society for more on
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.