Replacing deliberately destroyed bone marrow with the patient’s own stem cells may help stabilize aggressive forms of multiple sclerosis (MS), according to a pilot study in Greece that was published recently in the journal Neurology.
The researchers said their study, which followed 35 patients for an average of 11 years after transplant, proves the method, called hemopoietic stem cell transplantation, is feasible and that clinical trials should now be done to see if it offers an effective alternative to current treatments.
Study author Dr Vasilios Kimiskidis, of Aristotle University of Thessaloniki Medical School in Thessaloniki, and colleagues found that for 25% of patients who received the treatment, their MS was no worse 15 years later, as would normally be expected.
Kimiskidis told the press that bearing in mind clinical trials are now needed, “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” said Kimiskidis.
Multiple sclerosis (MS) is a disease where the body’s own immune system attacks myelin, the fatty covering that insulates nerve cell fibers in the brain and spinal cord, resulting in slower nerve signals.
According to the National Institutes of Health, no one knows exactly how many people have MS, but some estimates put the number of Americans with the disease at between approximately 250,000 to 350,000, and the number of people worldwide at over 2 million.
The treatment used in this study, which started in 1995, took bone marrow stem cells from the patients’ own bodies and transplanted them back after using a course of chemotherapy to wipe out the immune cells in the bone marrow, including those thought to be attacking the central nervous system.
The purified stem cells are thought to “reboot” the immune system.
The patients in the study had rapidly progressive MS and had tried a number of other treatments with little or no effect.
All were severely disabled with the disease. Their average score on the multiple sclerosis severity scale, a scale of disease activity where 0 is a normal neurological exam and 10 means death due to MS, was 6, which means able to walk with a cane or crutch (a score of 7 usually means the patient is wheelchair-bound). All patients had worsened by at least one point on the scale in the year before receiving the transplant.
The study results showed that after the transplant, the chance of patients having no worsening of the disease for 15 years was 25%. The chance was higher, at 44%, for those who had active brain lesions at the time of the transplant.
For 16 people, symptoms improved by an average of one point on the multiple sclerosis severity scale, after the transplant, and the improvements lasted for an average of 2 years. They also experienced a reduction in number and size of brain lesions.
However, two of the patients died as a result of complications linked to the transplant: one died 2 months and the other died 2.5 years after transplant.
“Long-term results of stem cell transplantation for MS: A single-center experience.”
A. Fassas, V.K. Kimiskidis, I. Sakellari, K. Kapinas, A. Anagnostopoulos, V. Tsimourtou, K. Sotirakoglou, and A. Kazis.
Neurology, 22 March 2011 76:1066-1070
Additional source: American Academy of Neurology (21 Mar 2011).
Written by: Catharine Paddock, PhD