Hope Where Almost None Existed

The second phase of a long-term clinical trial could lead to groundbreaking treatments in multiple sclerosis. The trial involved 24 people in Canada with aggressive relapse-remitting MS who underwent chemotherapy and a stem cell transplant to reboot their immune system.

In multiple sclerosis, the body’s immune system attacks myelin, the protective coating around the nervous tissue in the brain and spinal cord. The damaged myelin forms scar tissue called sclerosis, and the damaged nerve fibers disrupt and distort neurological impulses.

Three years after patients received this therapy, 100 percent were free from relapses.

Common symptoms include blurry vision, trouble walking, unclear speech, and difficulty thinking and processing information. More extreme cases of the disease can result in paralysis and death.

The typical treatment for MS depends on the type, which can range from occasional relapses to more aggressive types where patients have almost no recourse. There is no known cure, although a number of medications have proven effective interventions.

However, the clinical trial in Canada could set a new course for MS treatments. Patients who participated had their immune system depleted through chemotherapy. They then received a stem cell transplant — called hematopoietic stem cell transplantation, or HSCT — with cells collected from their own blood.

Three years later, 100 percent of them were free from any relapses and 70 percent remained free from any disease activity whatsoever. There were no indications the disease was progressing and no new lesions in the brain or spinal column. About 40 percent of the patients had reduced symptoms and disabilities.

Chemotherapy is traditionally associated only with cancer, and for good reason. The toll that a round of chemo takes on the body comes with its own risks. The National Multiple Sclerosis Society cautioned patients to get counsel from their neurologists before jumping to any conclusions.

Related: New Autoinflammatory Disease Discovered

“There are a number of known risks and toxicities associated with autologous HSCT, including the risk of death,” it said. “The main risk comes from the chemotherapy regimen … This makes the individual vulnerable to a wide variety of bacterial, fungal, and viral infections, and sepsis.”

All participants in this trial developed fevers after the treatment, which were indicative of infections and other toxicities. One patient died from complications. Lung and kidney problems and urinary tract infections have been known to accompany HSCT as well.

Pam Baumeister, a 43-year-old writer and watercolorist in Sandy, Utah, has been living with multiple sclerosis for three years. She first noticed the symptoms when the bottom portion of her vision became blurry. She visited a series of doctors until she met with a neurologist who identified her disease as relapse-remitting MS.

People who benefit most have “inflammatory relapse-remitting MS, can walk, have had MS for 10 years or less, and have not been helped by available disease-modifying therapies.”

Baumeister has done everything she can to slow the progression of MS and minimize its symptoms. She has eliminated sugar from her diet, as well as gluten and dairy, and she does yoga regularly. Although her symptoms are mild compared to other forms of the disease, she still says it has been a struggle to keep up enough energy for a balanced lifestyle.

“My right hand is always tingly, pretty much constantly pins and needles,” she told LifeZette. “When my MS flares up, my balance is worse. Just this last month, I had a flare-up where my left leg felt heavier and made it harder to walk.” But Baumeister says that of all her symptoms, chronic fatigue is her constant companion. “I’ve had to learn how to budget my energy,” she said.

And as a full-time creative worker and mother of four children, that energy gets depleted quickly.

She has infusions every five weeks to suppress her immune system, and she’s exhausted afterward. Every six months, she undergoes a series of tests to make sure she isn’t developing new lesions on her nerve tissue.

Baumeister might be the kind of patient who could benefit from this new treatment. The National Multiple Sclerosis Society said people who benefit most from HSCT have “inflammatory relapse-remitting MS, can walk, have had MS for 10 years or less, and have not been helped by available disease-modifying therapies.” But patients are still wary of chemotherapy.

[lz_ndn video=30973898]

“Full-blown chemotherapy is like poison, and it’s horrible for your body,” Baumeister said. “But I don’t want MS. If I could get rid of it, I would.” Even if patients were eager to participate, they would have a difficult time getting access to it.

There is only one clinical trial for HSCT being conducted in the U.S., and it’s taking place at Northwestern University and Rush University Medical Center — both in Chicago. Other than that, only the Fred Hutchinson Cancer Center in Seattle and Northwestern University use HSCT as a possible treatment for MS.

The treatment doesn’t appear to help patients with longstanding progressive MS, but it could still provide hope for the 2.5 million people worldwide who struggle with the disease. It may not be the right move for everyone — but for many, it could turn around the progression of an illness that so far has remained incurable.