You may have heard in the news recently about the success that some people with Multiple Sclerosis (MS) had, following a clinical trial at Sheffield’s Royal Hallamshire Hospital. It was reported that the trial was so successful that some of the patients were able to walk again.
The treatment was the subject of a recent Panorama programme- Can you Stop My Multiple Sclerosis? and involved the patients first undergoing extensive chemotherapy to destroy the parts of the immune system that cause MS. They were then treated with stem cells derived from their own bone marrow, which had the effect of resetting their immune system to a time before the MS.
This therapy is called AHSCT (Autologous Haematopoietic Stem Cell Transplantation) and was first used in leukemia patients in Baltimore, USA where Dr Richard Burt noticed that children who received this treatment lost all their immunisation immunity and he realised that this could have an application in the treatment of autoimmune diseases like MS, lupus (SLE), diabetes type 2 and Rheumatoid arthritis. In 1996 he carried out the first transplant on an MS patient and in 1997 he carried out his first transplant on an SLE patient.
Dr Burt’s AHSCT treatment in Chicago, for patients with severe lupus, in some cases was very successful (as the Lupus Foundation of America reports). They say that the early research (2006) has been promising with half the patients remaining disease free after 5 years and you can read some of these patient’s stories on The Northwestern University of Chicago’s DIAD website. There’s also an interesting talk by Dr Richard Burt there.
The Royal Hallamshire’s most recent study using AHSCT to treat MS is linked Dr Burt’s work and forms part of an international randomised trial he’s begun (MIST). The results were impressive; in 123 people with relapsing, remitting MS, the AHSCT treatment was linked to a 64% reduction in the level of disability, 80% of those treated had no relapses in 4 years and 87% had no worsening to their level of disability.
However, this treatment is still extremely experimental and carries with it significant risks. In America lupus SLE patients will only be considered for stem cell trials if all other forms of treatment have failed i.e. it’s a matter of life and death. The chemicals used are extremely toxic, the treatment challenging and complications such as infections can lead to long hospitalisation. The therapy is very radical and there have been a small number of deaths due to treatment related complications. At £30,000 for each treatment, it is also expensive and it will be years before the long term success or side effects are known.
That said these findings for MS patients do seem to offer real hope for the treatment of all autoimmune diseases in the future.