An aggressive chemotherapy and stem cell treatment has halted the progression of multiple sclerosis (MS) in a small group of patients. This exceptionally risky but pioneering technique featured the complete but temporary destruction of their immune systems, as described in the landmark study published in The Lancet.
Twenty-four patients aged between 18 and 50 were chosen for the procedure; they were originally given poor prognoses, meaning that their condition was having or going to have a severe effect later in life. After undergoing this medical trial, 23 of them are now showing no new signs of the disease and experienced no relapses, and some have recovered their mobility. The 24th patient, sadly, died as a result of the procedure.
Although the treatment has its limitations, including its very small sample size and its lack of control group, medical researchers have hailed it as huge step forward in the fight against MS, which is a truly debilitating condition.
“I hesitate to use the c-word. A cure would be stopping all disease moving forward and repairing all damage that has occurred,” Dr. Mark Freedman, the Director of the Multiple Sclerosis Research Unit at Ottawa Hospital and coordinator of the study, told the Guardian. “As far as we can ascertain no new damage seems to occur beyond the treatment and patients don’t need to take any medication, so in that sense, I think it has induced a long-standing remission.”
MS occurs when the linings of nerve cells in both the brain and spinal cord are damaged by the body’s own malfunctioning immune system. A damaged central nervous system limits its ability to send signals to various parts of the body.
Although symptoms can vary, problems with locomotion, balance, vision, and processing thoughts are common. The condition is two to three times more prevalent in women than men. Treatment is difficult and varyingly effective depending on the progression of the condition and the immune system of the individual.
One existing method is to suppress the immune system using conventional chemotherapy, which slows down its destructive attack on the body’s nerve cells. Stem cells harvested from the bone marrow of the afflicted patient are then introduced to the patient’s bloodstream.
These so-called haematopoietic stem cells (HSCs) are the type to differentiate into all other blood cells. After purification to remove the ones that may trigger MS, they find their way through the body and into the bone marrow once again.
Over time, they slowly rebuild the body’s immune system by turning into new cells that are no longer programmed to destroy the patient’s nerve cells. Although this is shown to be effective, patients are shown to have a relapse in MS after a few years.
This treatment is almost identical to the new study’s trial method, but in this case, the immune system is completely annihilated. The point of doing this is to give the stem cells the best chance of rebuilding the immune system without any MS triggers in it. The problem, unfortunately, is that during this window of time, the patients are vulnerable to life-threatening infections.
Indeed, this trial led to a single death of a patient who, during this time, suffered from a bacterial infection that caused blood poisoning, as well as severe liver damage. However, these patients, faced with a life of severe MS or a potential cure through an aggressive, risky treatment, took the groundbreaking path – and, 13 years on, their MS hasn’t worsened in the slightest.
Over 2.3 million people worldwide are thought to suffer from MS. Although this treatment requires more investigation, it’s clear that it certainly offers one thing for MS patients that has been sorely lacking for some time: hope that, perhaps soon, the condition can be stopped dead in its tracks.