Stem-cell therapy slows progression of multiple sclerosis

A stem-cell therapy usually used to treat blood cancer has been shown to be effective at slowing progression of multiple sclerosis (MS) symptoms.

Autologous haematopoietic stem cell transplantation (aHSCT) – commonly known as a bone marrow transplant – has been tested as a treatment for MS for over a decade. Researchers from Uppsala University, Sweden reviewed records of 174 patients with the relapsing-remitting form of the condition, who had undergone stem-cell transplantation using their own stored stem cells, not those from a donor. They discovered that 73 percent of the patients had no disease activity five years after treatment, which reduced to 65 percent after ten years.

'Our findings demonstrate that aHSCT for [relapsing-remitting MS] is feasible within regular healthcare and can be performed without compromising safety,' the researchers wrote in a paper published in the BMJ Journal of Neurology, Neurosurgery and Psychiatry.

This was an observational study, meaning that there was no control group for comparison. However, it follows a randomised clinical trial conducted in 2019 by researchers from Northwestern University, Illinois, the results of which were published in JAMA. This earlier research found that 110 patients with relapsing-remitting MS benefited from aHSCT, with only five percent of those patients not seeing an improvement in their symptoms.

'Our study corroborates the results observed in the only randomised controlled trial conducted to date. We believe that aHSCT could benefit a greater number of MS patients and should be included as a standard of care for highly active MS,' said the Uppsala University researchers.

MS is an inflammatory disease with no known cure. It affects around three million people worldwide and presents varying symptoms, including fatigue, difficulty walking, muscle stiffness and spasms, vision problems and problems with balance and co-ordination. In the relapsing-remitting form of the condition, the patient relapses and experiences symptoms, followed by periods of recovery without symptoms.

MS is believed to be an autoimmune disorder, where the body's immune system attacks its own tissues. Because of this, aHSCT was purported as a treatment option, as it was hypothesised that a patient's self-reactive immune system could be eliminated and replaced using stem-cell transplantation.

That said, aHSCT is not without risk, as the patient must firstly undergo chemotherapy and radiotherapy to wipe out their immune system. Afterwards, their immune systems are rebuilt using their own blood stem cells that are harvested before treatment.

Senior author Dr Joachim Burman explained to Technology Networks: 'Another name for aHSCT is high-dose chemotherapy with stem cell support, which perhaps better describes the procedure'.

The researchers report that there were very few serious adverse events and no treatment-related mortality, suggesting that the procedure could potentially be performed quite safely in routine healthcare settings.

'Another important finding is that the treatment effect is durable. Ten years after the procedure only 35 percent had evidence of disease activity and only 11 percent needed to restart some other treatment. It is likely that some of the patients will never need treatment for MS again,' continued Dr Burman.

The researchers are currently investigating why some of the patients relapse after treatment, while others can stay in remission with no need for further treatment for 20 years or more.