Is Stem Cell Therapy Safe for Relapsing-Remitting Multiple Sclerosis Treatment?

Autologous hematopoietic stem cell transplantation or aHSCT, often used to treat blood cancers, was also demonstrated to be safe and effective for treating relapsing-remitting Multiple Sclerosis (MS) (1^✔ ✔Trusted Source
Haematopoietic stem cell transplantation for treatment of relapsing-remitting multiple sclerosis in Sweden: an observational cohort study

Go to source). Autologous hematopoietic stem cell transplantation or aHSCT, involves harvesting stem cells from the person’s own bone marrow or blood followed by chemotherapy and antibody treatment.

Relapsing-remitting multiple sclerosis is a type of multiple sclerosis (MS) that occurs when you have flare-ups (also called relapses or exacerbations) of symptoms followed by periods of partial or complete recovery (remission).

Stem Cell Therapy Ebbs Relapsing-Remitting Multiple Sclerosis Progress

Emerging evidence indicates that it is suitable for treating relapsing-remitting MS— characterized by distinct inflammatory episodes that cause varying degrees of residual disability. However, aHSCT has yet to be included in most national clinical guidelines.

The researchers therefore wanted to assess its safety and effectiveness when used in routine healthcare rather than under clinical trial conditions.

They identified 231 patients with relapsing-remitting MS, 174 of whom had been treated with aHSCT before 2020: 2004 was when the first of these patients had been treated with aHSCT. Their average age when treated was 31, and nearly two-thirds (64%) were women.

How well aHSCT worked was evaluated by analyzing data collected from the Swedish MS registry. And its safety was assessed by scrutinizing the patients’ electronic medical records for the 100 days following the procedure.

On average, patients had their disease for more than 3 years and had received an average of 2 lots of standard treatment (disease modifying drugs) before aHSCT; 23 had not had any treatment.

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Around nearly 3 years, on average, after undergoing aHSCT, 20 patients (11%) were given a disease-modifying drug. This study showed no evidence of disease activity in nearly 3 out of 4 (73%) of those treated after 5 years and in almost two-thirds (65%) after 10 years.

Among the 149 MS patients with some disability to begin with, more than half (54%;80) improved, just over a third (37%; 55) remained stable, and around 1 in 10 (9%;14) got worse.

Insights on Efficiency of Stem Cell Therapy in Multiple Sclerosis

The annualized relapse rate was 1.7 in the year before aHSCT and 0.035 during the monitoring period, which averaged 5.5 years. Or put another way, on average, a patient had 1.7 relapses in the year before aHSCT treatment, and 1 relapse every thirtieth year after aHSCT treatment.

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Five patients required intensive care, and 61 developed a bacterial infection within 100 days of treatment. Febrile neutropenia (low white cell count accompanied by a high fever) was the most common side effect, affecting 68% of patients.

Other viral infections were verified in 23 patients (13%). Herpes zoster reactivation was documented in 3, and 3 had a confirmed localized fungal infection. None died as a result of their treatment.

This is an observational study, with no comparative group, which precludes definitive conclusions, the researchers acknowledge. Nevertheless, they summarize: “Our findings demonstrate that aHSCT for [relapsing-remitting MS] is feasible within regular healthcare and can be performed without compromising safety.”

Reference:

1. Haematopoietic stem cell transplantation for treatment of relapsing-remitting multiple sclerosis in Sweden: an observational cohort study - (https://jnnp.bmj.com/content/early/2023/08/14/jnnp-2023-331864)

Source: Eurekalert