Departments | February 2009
In The News
Stem Cell Therapy Reverts Early-Stage MS
A new stem cell transplant treatment may allow MS patients to revert back to a clear slate by "resetting" their immune systems. Published in the online edition of The Lancet Neurology (January 30), a study from Northwestern University shows that autologous non-myeloablative hematopoietic stem-cell transplantation reverses neurologic dysfunction of early-stage multiple sclerosis patients.
The study involved 21 patients, ages 20 to 53, with relapsing-remitting MS that had not responded to at least six months of interferon beta treatment. The participants had had MS for an average of five years. Peripheral blood haemopoietic stem cells were mobilized with 2g/m2 cyclophosphamide and 10íg/kg/day filgrastim. The conditioning regimen for the haemopoietic stem cells was 200mg/kg cyclophosphamide and either 20mg alemtuzumab or 6mg/kg rabbit antithymocyte globulin. After an average follow-up of three years after transplantation, 17 patients (81 percent) improved by at least one point on the Kurtzke expanded disability status scale. The disease also stabilized in all patients.
Patients in the phase I/II trial continued to improve for up to 24 months after the transplantation procedure and then stabilized. They saw improvements in areas in which they had been affected by MS, including walking, ataxia, limb strength, vision, and incontinence.
As part of therapy, researchers treated patients with chemotherapy to destroy their immune system. Next, they injected patients with their own immune stem cells, obtained from the patients' blood before the chemotherapy, to create a new immune system, a procedure known as autologous non-myeloablative hematopoietic stem cell transplantation.
"We focus on destroying only the immune component of the bone marrow and then regenerate the immune component, which makes the procedure much safer and less toxic than traditional chemotherapy for cancer," says Richard Burt, MD, chief of immunotherapy for autoimmune diseases at the Feinberg School of Medicine at Northwestern University.
For more information: The stem cell trial from which these initial results were reported is ongoing. For more information or to see if one of your patients is eligible for the national trial, go to: www.clinicaltrials.gov/ct2/show/NCT00273364.
This Month's Issue
Rachana Gandhi Mehta, MD; Vanessa Baute Penry, MD; and Herbert Lloyd Bonkovsky, MD