New Pre-HSCT Treatment May Be the Future, but HSCT with Lower Dose Chemo is Right Choice for MS Patients Now
News that scientists in the U.S. 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.
In 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 the Stanford Institute for Stem Cell Biology and Regenerative Medicine, and director of the Ludwig 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.
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 Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.
Comments
Elena
Ian, thank you for your opinion! Totally agree with you. It's still years to finish clinical trials for humans:(
Thank you Elena. You are right, clinical trials can take so very long.
Sharon Therrien
If they are looking for people for the clinical trials I would be more than willing.
Olivier
Too bad because Stanford is almost next door, just a few hours away depending on traffic.
May be, based on how promising this new way to do it without using high dose of chimio is, they could be faster than "years away".
You don't need 'high dose' chemo to treat MS; lower dose does just fine.
Olivier
Ok good to know but if we want the insurance to pick up the tab, it has to be FDA approved.
If it is not FDA approved we are talking to pay about $30000 isn't it?
Phil Longford
Stem cell treatment, WITHOUT chemo, seems pointless, and smacks of con artists, ripping off vast amounts, from desperate people.
Clinics around the world, (in probably very un-regulated areas) popping up, charging vast amounts, for treatments that clearly do not work, happens so often.
With chemo, there is the added possible side effect, of death. But to many, that is a risk work taking. (Death, and Taxes!)
Good luck with your treatment. We are watching!!
Hi Phil, although this is my personal opinion, I agree with your comments about stem cell treatments without chemotherapy as far as things are at the moment. Only time will tell if the researchers will perfect a new treatment that works in humans.
What many people fail to realise is that it is the chemotherapy that kills off the faulty cells - and the new immune system would grow without stem cells being transplanted. The stem cells just speed up recovery.
With chemo, there are two protocols, non-myeloablative that includes lower dose chemo that is easier to tolerate and is used in the vast majority of HSCT centers, and myeloablative that includes higher dose chemo that is more aggressive and not so easy to tolerate. The Canadian trial, in which one person died (of 24 participants), used the aggressive myeloablative protocol.
Mortality rate of the less-aggressive, lower dose chemo non-myeloablative protocol is about 0.5%.
Darlene Nesthus
There has been work for treatment for MS way too long. My quality of life is getting real bad and my husband is getting fed up with having to help me with everything. Something needs to be done NOW. I'm 57 yrs and can't wait for another 10 yrs!!! PLEASE PLEASE PLEASE find a solution for MS soon!!!
Hi Darlene, I agree. Researching new treatments is fine but we really need a cure.
Phil Longford
Mortality rate of 0.5% would probably be acceptable to most people with reasonably advanced MS. To take a 1 in 24 risk of death, the MS would have to be quite bad. And, if really bad, I understand treatments are even less likely to work. As well as Baric oxygen treatment, and watching the diets (I know you are sceptical about that one!) I have just started doing Yoga (specifically for MS). First few sessions, half killed me. But getting easier. As for Darlene getting worried about her husband, getting fed up having to help, he should not regard it as a burden, to be able to help the person he married. In sickness and in health! Maybe I should put that to my wife? Have to be very drunk! Or stoned. Medical cannabis oil being recommended. Where can I get some, and does it make good salad dressing?
Mike Strasheim
What clinics are in the US that does that does low dose chemo HSCT?I would certainly look at that option Thanks
Hi Mike, out of the many stem cell clinics in the USA, only one haas ever done HSCT of any kind and but mostly trials and I cannot guarantee what they are oing right now. That is Nirthwestern, in Chicage.
The nearest non-myeloablative HSCT center to the US is Clinica Ruiz in Puebla, Mexico. While I cannot give any recommendations, I can tell you that you I have only ever heard good reports about its work. Good luck.
Lisa
Hi everyone from Canada! I've had MS for 15 years. And in the last 4 years, I've somewhat deteriorated. I'm desperately pushing my neurologist to put me forward for this treatment in Ottawa. The pioneer Doctor of this very treatment is there. But I need to get 'worse' until I can be put on the list. I've even said dramatic things like 'I want cancer' and how I long to be in a wheelchair to finally be added to the list. Ironically, I say these things...because I want to live. Not die. (I'm 47). I have to wait for my new MRI now, in May to hear anything. If I get it through the proper channels, luckily, it's covered by our health plan. Yes, there's risk, however, I believe most MS'ers would choose to take the risk! Thank you Ian for identifying the real difference in the treatments. A 'deal' in buying a car is one thing. But in life....it's priceless...and
I'll pay if I have to...best wishes.
Lisa
Hello Lisa, I am glad my explanations have helped you. I really hope you are successful. Does your health plan only cover treactment in Canada or would it pay for treatment elsewhere too?
Lisa
Hi again Ian...it's called OHIP. I believe the acronym for Ontario Health Insurance Plan. We pay for it with our taxes. Canada has quite a high tax percentage. For example, I pay close to 50%! It's high, but things like this are covered. Lesser earning incomes are taxed lower...and no, they wouldn't
cover the treatment anywhere else...just Canada.
Troy
Ian, I'm going in for MRI imaging of my brain and spinal cord, with and without contrast looking for MS. The neurologist uses a .3 Tesla machine, and won't accept other images say from a 1.5 or 3T machine. Do you have any thoughts on this? Im under the impression that the newer, more powerful magnets produced better results. I appreciate any help you could give. I'm trying to choose which path to take and right now the medical community is much less helpful or willing than the patients themselves.