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.
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