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New Pre-HSCT Treatment May Be the Future, but HSCT with Lower Dose Chemo is Right Choice for MS Patients Now

on August 21, 2016
News that scientists in the US are working to find a new pre-HSCT treatment to carry out stem cell transplants without the need for chemotherapy, as published in Multiple Sclerosis News Today, leaves me with mixed feelings.

While such a development could potentially be great news and an important development, it must be remembered that such a method is still years away.

MS ribbonIn the meantime, it needs to be recognized that chemotherapy is not just a part, it is the key part of stem cell therapy. It is chemotherapy that carries out the most important task of suppressing the faulty immune system that attacks the myelin sheath; the stem cells just help the healthy immune system rebuild more quickly — something it would do without the new stem cells, but over a much longer time.

That is why people often say ‘no chemo, no cure’.

My concern is that there are too many clinics trying to lure people into stem cell therapy without chemo and they could possibly latch onto this news, allowing patients to gain a false impression of what they are being offered.

New pre-HSCT Treatment Is Still Being Studied

Let me make my position quite clear: Right now, the only stem cell therapy for MS patients worth considering is autologous non-myeloablative HSCT (hematopoietic stem cell transplant). Autologous because it harvests your own healthy bone marrow stem cells for later transplantation; non-myeloablative because that protocol involves much lower doses of chemotherapy drugs, making it easier for your body to tolerate than the myeloablative’s aggressive chemotherapy protocol.

Myeloablative HSCT was originally developed as a cancer treatment, for which higher doses of chemotherapy are advisable. But the vast majority of clinics that now offer this treatment for MS have dropped the myeloablive protocol in favor of the safer non-myeloablative one.

I shall be watching the developments at Stanford University School of Medicine with great interest as scientists battle to develop a working method to suppress the human immune system without using chemotherapy. According to their study, “Hematopoietic stem cell transplantation in immunocompetent hosts without radiation or chemotherapy,” published in the journal Science Translational Medicine, the method has been successfully tested in mice. But it still has a long way to go before it’s proven safe and effective in humans, and if so, it could revolutionize MS treatment.

If it works in humans like it did in mice, the researchers say they would expect that the risk of death from blood stem cell transplant would be effectively eliminated, according to the study’s senior author, Dr. Judith Shizuru, MD, PhD, and a professor of medicine at Stanford.

“If and when this is accomplished, it will be a whole new era in disease treatment and regenerative medicine,” said Dr. Irving Weissman, a study co-author and professor of pathology and developmental biology at Stanford, who is also the director of theStanford Institute for Stem Cell Biology and Regenerative Medicine, and director of theLudwig Center for Cancer Stem Cell Research and Medicine.

The words “if” and “when” are key here. Until that time comes, in my opinion, autologous HSCT using the non-myeloablative protocol is the only real choice for MS patients who want to have stem cell therapy.

 This article, written by me, first appeared on MultipleSclerosisNewsToday.com.

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Ian Franks
Ian Franks is our Chief Columnist and an MS Patient Specialist. He enjoyed a successful career as a journalist, from reporter to editor, in the print media; during which he gained a Journalist of the Year award in his native UK. He was diagnosed with MS in 2002 but continued working until mobility problems forced him to retire early in late 2006. He now lives in the south of Spain and uses his skills to write his own flourishing specialist Health & Disability blog at www.50shadesofsun.com. Besides MS, Ian is also able to write about both epilepsy and cardiovascular matters from a patient’s perspective and is a keen advocate on mobility and accessibility issues.

6 Responses to “New Pre-HSCT Treatment May Be the Future, but HSCT with Lower Dose Chemo is Right Choice for MS Patients Now”

  1. SUE GAYLARD says:

    I HAVE HAD MS SINCE 1987, BEING THE PPMS TYPE. IN 2000 I HAD A HYSTERECTOMY AND WAS GIVEN PLASMA AS I HAD BEEN BLEEDING A LOT BECAUSE OF FIBROIDS. NOT LONG AFTER THIS SURGERY MY MS WENT INTO COMPLETE REMISSION AND ALL MY SYMPTONS DISSAPPEARED, UNFORTUNATELY IN OR AROUND 2013 THEY STARTED TO APPEAR AGAIN IN A SIMILAR PROGGRESSION. I AM STILL WONDERING WHAT HAPPENED AND CAN I REPLICATE THIS REMISSION AGAIN ??

    • ian0811 says:

      Hello Sue, I am not a doctor so I am unable to offer you medical advice but for more information abbout PPMS, I recommend you join one of the PPMS Facebook groups. There is a drug currently being trialed that is thought could be approved as a therapy for PPMS. Also, if you are thinking about HSCT, I know of many PPMS patients who have been treated with it.

  2. Stefanie says:

    Dear Ian
    Thanks so much your recent articles (also about the FDA event to take place soon). I have RR MS and am on Rebif (interferone) since over 10 years. My EDSS is at 1.5-2 and my last relapse was 6 months after I started Rebif, then had no relapses anymore. But I of course have remaining myelin damage in my vertebral column with symptoms to which I just had to get used to and just live/work with…pins/needles in hands and feet + insensibility/feeling of swollen feet, in parts of my feet + recently bowel disturbances similar to IBS.

    But one can never be sure when and to what stage things could get worse and therefore I have always been glancing at stem cell developments (just thinking: in case would need treatment in future, should I get worse).

    Since you seem to have thoroughly studied the issue of stem cells treatments and I understand HSCT with low dose chemo seems at this stage in time the best treatment, I have a few questions:

    – has such treatment repaired myelin damage ? i.e. are there chances that one could really get symptom-free?

    – is such treatment helpful in terms of prevention or only in terms of repair? i.e. if one has undergone treatment and may be “repaired” – will MS, not with time cause again further myelin damages? Which would then require another treatment/additional intervention? or has within HSCT studies the chemotherapy “reset” of the immune system also shown prevention of further damages?

    Many thanks in case you may have come across in HSCT (with low dose chemo studies) performed about these aspects. And thanks so much for your work on keeping us up-to date on your great blogs!

    • ian0811 says:

      Hello Stefanie, I need to start by saying that I am not a doctor and this is not medical advice. Now I’ll guve you the benefit of my experience. HSCT is only vclaimed to halt the disease, t stop it progressing by stopping further demyelination. However, there have been fantastic results that far out-perform those claims. People can do far more than before treatment, in other words, the MS has not just been stopped. To a certain degree it has been reversed. Moscow has reported long-term results of 10 years without a relapse. Prevention of further damage is the aim but results appear much better in most cases.
      I believe in HSCT that I am going to Moscow next month for four days of tests and assessment as to whether or not I am a suitable candidate for the therapy. I shall be keeping you all up to date through my website.
      There is one thing to add, if you wanrt HSCT you should get it sooner rather than later.

      • Stefanie says:

        Many thanks Ian! Wish you all goes best for you in Moscow!

        Would you know if the clinic in Moscow has published some research studies or results, and if there is a web-link to those studies in English? Do they cooperate in their research with Richard Burt in Chicago and apply same procedure as in the ongoing clinical trial?

  3. Stefanie says:

    Hi Ian, hope you had a good start of the new year! Am just curious: how did your suitability tests in Moscow go? Wishing you all the best!

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