Stem Cell Transplantation May Help Some Multiple Sclerosis Patients
Hematopoietic stem cell transplantation, which is commonly used for patients with blood and bone marrow cancers, has been the focus of several studies for people who have multiple sclerosis. Now a new report from an Australian team offers some insight into this treatment approach, including which MS patients seem to be the most likely to benefit from it.
Hematopoietic (meaning “formation of blood or blood cells”) stem cell transplantation for multiple sclerosis is a technique in which a patient’s stem cells are harvested from bone marrow or peripheral blood. The rest of the person’s immune cells are depleted using radiation, chemotherapy, or both.
The harvested stem cells are then returned to the body via intravenous infusion. Over time, the new stem cells make their way to the bone marrow and produce new, healthy cells and eventually repopulate the body with the new immune cells—cells that should not attack myelin or brain tissue.
The Australian team reviewed what is known thus far about using hematopoietic stem cell transplantation for multiple sclerosis, including both animal and human data. According to the authors, “preclinical data derived from animal models of MS…have provided clear identification of multipotent stem cells that can reconstitute the immune system to override the autoimmune attack of the central nervous system.”
In addition, based on their review of previous studies, they pointed out the following observations:
- Some of the methods used to deplete the immune system can be extremely toxic to some individuals, especially the elderly, which means this treatment approach may not be appropriate for these patients
- Individuals with active MS in particular seem to respond to treatment
- People with extremely high disability may continue to worsen even though they have undergone stem cell transplantation
One factor stressed by the reviewers is the intricate nature of this hematopoietic stem cell transplantation process. For example, it’s a challenge to harvest the correct stem cells, since hematopoietic stem cells make up a mere 0.01 percent of the body’s cells that contain a nucleus.
In addition, the cells used as replacements should include only immature cells, since the use of mature cells introduces the risk of retriggering the disease process.
Use of hematopoietic stem cell transplantation for multiple sclerosis is still in the trial stages. A quick search on ClinicalTrials.gov showed one study active and not recruiting and one now recruiting, but it’s important to check periodically as the number and status of studies always change.
Other stem cell research also may be underway. Anyone who is interested in learning more should talk to their doctor about available or upcoming trials.
Bakhuraysah MM et al. Hematopoietic stem cell transplantation for multiple sclerosis: is it a clinical reality? Stem Cell Research & Therapy 2016; 7:12 Online 16 Jan 2016
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