Desperate Times

Multiple sclerosis (SM) is a disease caused by a malfunction of the immune system, where instead of defending the body, it attacks it instead. It kills the insulating myelin sheath, resulting in progressive loss of the ability to control limbs.

A new high risk type of stem cell transplant may be key to halting multiple sclerosis symptoms in long-term sufferers. A combination of chemotherapy and stem cells has resulted in some cases of reversal of the damage MS has caused.

The treatment, autologous haematopoietic stem cell transplantation (aHSCT), has fully halted clinical relapses and the development of new brain lesions in 23 of 24 patients with MS for a prolonged period without the need for ongoing medication.

Desperate Measures

The principle behind the new treatment is rooted in a more benign treatment for MS. Regular aHSCT involves harvesting bone marrow stem cells from the patient, using chemotherapy to suppress the patient's immune system, and reintroducing the stem cells "reset" the immune system. However, this often results in relapses after a time.

The researchers from the University of Ottawa tested the complete destruction of the immune system, instead of mere suppression. After destroying the immune system, the stem cells had to completely rebuild it.

The trials, published in The Lancet, involved 24 patients aged 18-50 who had previous treatments which did not control the MS. After 3 years, 6 patients (37%) were able to reduce or stop receiving disability insurance and return to work or school. Eight (33%) of the 24 patients had a moderate toxic effect and 14 (58%) patients had only a mild toxic effect related to transplantation.

But even with the impressively positive results, clinicians are still wary of the treatment. The trials had a small sample size (24), and resulted in the death of one of the volunteers due to the drastic measures the treatment entails.

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