Mesenchymal Stem Cell Transplant Safe and Helps Delay MS Progression, Analysis Shows

Transplanting patients’ own mesenchymal stem cells (MSCs) is a safe therapeutic approach and can delay disease progression in people with multiple sclerosis (MS), a meta-analysis review shows.

The study also showed that cells transplanted to the spinal cord (intrathecal injection) were associated with significantly slower disease progression rates, compared to cells delivered into the bloodstream.

The review “Autologous Mesenchymal Stem Cell Transplantation in Multiple Sclerosis: A Meta-Analysis” was published in the journal Stem Cells International.

The use of adult stem cell therapy, such as MSCs, as a therapeutic strategy for MS is increasing. MSCs are found in several parts of the body, including the bone marrow, skin, and fat tissue.

Autologous MSCs transplant involves collecting a patient’s MSCs and expanding their numbers in the lab. Cells are then infused back into the patient’s blood (intravenous injection), or into the fluid surrounding the spinal cord (intrathecal injection).

In this review, researchers in China performed a meta-analysis of published studies across several databases to assess the effectiveness and safety of autologous MSCs transplant in MS.

They reviewed nine studies (eight open-label, and one randomized study) encompassing 133 MS patients, including those with relapsing MS, primary progressive MS, or secondary progressive MS.

In eight studies the MSCs were collected from the bone marrow, and in one study from the fat (adipose) tissue. In three studies cells were transplanted into the patient’s blood (intravenous injection), and in five into the fluid surrounding the spinal cord (intrathecal injection). One study used both strategies for the transplant.

Patients were followed for six months to eight years post-transplant. Patients’ outcomes were assessed by evaluating the changes in expanded disability status scale (EDSS) — a method of quantifying disability in MS, with higher EDSS scores indicating greater disability — and magnetic resonance imaging (MRI).

The analysis revealed that all nine studies reported common adverse side effects, including low fever, slight headache, backache, nausea and vomiting, bacterial meningitis after spinal injection, and urinary/respiratory infections. No transplant-related deaths occurred during follow-up. Two deaths were reported at eight and 40 months after completing the study, but none were related to the transplant.

Regarding the treatment’s effectiveness, results showed the disease progressed at a rate of 16% by six months and 35% after one year. During the follow-up, 72% of patients reached the status of no evidence of disease activity (NEDA) — meaning no disability progression, no clinical relapse, or no new MRI lesions — at six months, and 62% after one year.

The team also found that transplant by intrathecal injection was associated with significantly lower six-month and one-year progression rates compared to intravenous injection.

No significant differences between age, EDSS, and MS duration were found in the groups.

Overall, in “this meta-analysis, we demonstrate the safety of aMSCs [autologous MSCs] for the treatment of MS,” researchers wrote, “with the largest benefit profile obtained in patients with aMSCs intrathecal injection.”

“All in all, comprehensive consideration of results indicate that aMSC transplantation is safe, and to better evaluate the efficacy more studies need to be investigated in the future,” the team stated.