MS news notes: Stem cell transplant, artificial intelligence

Columnist Ed Tobias comments on the week's top MS news

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by Ed Tobias |

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Welcome to “MS News Notes,” a column where I comment on multiple sclerosis (MS) news stories that caught my eye last week. Here’s a look at what’s been happening:

Lemtrada or stem cell transplant?

While the U.S. Food and Drug Administration has not yet approved stem cell transplants to treat people with MS, there is growing interest in the procedure because many believe that transplants are superior to currently available disease-modifying therapies (DMTs).

The MS News Today story “Stem cell transplant outperforms Lemtrada in MS treatment: Study” reports on research in Lithuania involving 50 people with highly active disease, comparing stem cell transplant with one of the most effective DMTs, Lemtrada (alemtuzumab). In the study, 31 people were treated with autologous hematopoietic stem cell transplant (aHSCT), and 19 were treated with Lemtrada.

“Five years after treatment onset, significantly more patients given aHSCT were free of MRI activity (69.6% versus 95.7%), relapses (54.5% versus 75.1%), and disability worsening (57.1% versus 90.9%) than with Lemtrada,” the story notes.

The researchers said it appears that stem cell transplant not only halted worsening disability in the patients, it also improved disability measures. On the other hand, they noted that Lemtrada “may halt disability progression early in the course of highly active [relapsing-remitting MS, or RRMS], but disability starts accumulating in later stages.”

I was treated with Lemtrada in late 2016, when I was 68 years old. Although I had secondary progressive MS, not highly active RRMS, I thought its potential benefits were worth it. Several years later, I believe they were. My disease progress has held fairly steady, and a couple of symptoms have eased. Would I have chosen a stem cell transplant if given the chance in 2016? Possibly, but not probably. I think I would’ve been more likely to do it had I been younger.

The researchers in this study concluded that “more clinical trials of HSCT on disease stabilization and progression reversal in patients with severe disability” are warranted.

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Early MS MRI markers linked to worse disability in 10 years time

An artificial intelligence tool to monitor your MS

Tracking MS lesions is a critical part of MS care, as the story “AI tool has potential to better track MS lesions over time: Study” notes. These lesions are usually measured by a radiologist who looks at an MRI scan. Of course, that method can open the door to human error.

This study reported on an artificial intelligence (AI) program called iQ-MS that is designed to quantify MS lesion volume and brain atrophy. Researchers reviewed the MRIs of 397 people with MS in three ways: at the patients’ care clinics, by experts at an MRI reading laboratory, and by iQ-MS. The iQ-MS system accurately identified 93.3% of the scans with new or enlarging lesions. The MRI lab, meanwhile, identified 85% of those, and the clinics identified only 58.3% of them. The researchers noted that the AI tool was especially better than humans at identifying existing lesions that had grown over time.

The researchers cautioned, however, that AI tools are limited in scope and can’t notice things they haven’t been specifically programmed to detect. Even so, the researchers said the use of tools likes iQ-MS “has the potential to enhance both real-world, clinical-imaging disease-specific research and the precision management of individual patients with MS.”

That seems like a good case for using AI in collaboration with a human radiologist.

How do you feel about a tool like iQ-MS being used to monitor your MS in the future? Please share your thoughts in the comments below.


Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis.

Comments

Carl Craig avatar

Carl Craig

First Ed, thank you for putting out such great information. Always helpful, insightful, and definitely informative.

Regarding the use of AI in the evaluation of MRI data, I believe this will bring about a very significant advancement in disease monitoring. While I do not believe we are ready to replace Radiologists and their evaluation, helping them to sort through, store and compare data stored in terabytes can only advance the practice. I no longer do "long division". That practice disappeared with the advent of affordable calculators. Similarly, Radiologists could spend more time evaluating differences or changes that are pointed out to them vs. looking for them

Thank you for the opportunity to voice my opinion.

Carl

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Ed Tobias avatar

Ed Tobias

Hi Carl,

Thanks for taking the time to comment and I'm glad you think what I write is helpful. I agree with you about AI being another tool in a radiologist's toolbox. My cousin is a radiologist and I'll be very interested in hearing what he thinks about this the next time I see him.

Ed

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James charleston avatar

James charleston

I have Ms just trying to understand the Ms . Doctor William Meader of UAB Birmingham,Alabama is handling my case

Reply
Ed Tobias avatar

Ed Tobias

Hi James,

I hope your neurologist can help you understand. Don't be afraid to ask him questions. You can also find a lot of useful info by searching on this website and you can ask questions in our MS Forums area - https://multiplesclerosisnewstoday.com/forums/

Ed

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R. Eigler avatar

R. Eigler

Ed, John Connor's column has gone silent. This is bad/sad/unfortunate for all of us, who relied on his voice that mixed reality and humor.
Please convey to him and his family just how valuable his ability to speak truth meant to the MS community.
R. Eigler

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Ed Tobias avatar

Ed Tobias

That's a great description of John's writing. I understand that he's left MS News Today but I don't know why. I've sent your comment to one of our managers and, perhaps, he can pass it along to John.

Ed

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David Marsh avatar

David Marsh

Great Post! The convergence of stem cell transplant and artificial intelligence in MS news signals a transformative era in the understanding and management of multiple sclerosis, emphasizing a more personalized and data-driven approach to treatment.

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Ed Tobias avatar

Ed Tobias

Thanks, David. The combination of man and machine should be a help and I hope it will mean, among other things, a faster diagnosis.

Ed

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