The treatment, which was developed to treat cancers such as leukaemia and lymphoma and is being used at the Royal Hallamshire Hospital, Sheffield, is the first to significantly reverse disability of MS in certain patients.
MS is an immune-mediated disease of the central nervous system, which has no cure. Although no one understands the exact cause of this illness, doctors believe that in susceptible individuals something triggers the immune system to attack the brain and spinal cord, leading to inflammation and degeneration resulting in disability.
The treatment, known as autologous haematopoietic stem cell transplantation (HSCT), aims to reverse this mechanism destroying the dysfunctional immune system causing the MS with a high dose of chemotherapy. This is then rebuilt with stem cells taken from the patient’s own blood which are harvested and stored before being transplanted back into the patient’s body.
The harvested stem cells are then infused back into the body where they grow new blood and bone marrow cells after two to three weeks. The regenerating immune system is effectively ‘rebooted’ allowing the inflammation in the brain and spinal cord to subside and healing to occur. This resulted in some wheelchair-bound patients to regain use of their legs. One patient, who had been blind, was able to see again.
Professor Basil Sharrack, Consultant Neurologist at Sheffield Teaching Hospitals NHS Foundation Trust, said: “Since we started using this treatment in a small number of patients with severe inflammatory disease who had failed to respond to standard therapies, some of the results that we have seen have been very encouraging. The treatment is not suitable for everyone because it has a degree of toxicity and patients need to be quite fit to withstand the effects of the chemotherapy. This treatment is only suitable for patients with relapsing remitting disease that have had two or more significant relapses in the previous 12 months, failed to respond to standard treatment and who had the illness for no more than 10 years. This treatment is not effective in in patients with primary or secondary MS. These initial results now need to be confirmed in a larger randomised clinical trial.”
Professor John Snowden, Consultant Haematologist and Director of Bone Marrow Transplantation at Sheffield Teaching Hospitals NHS Foundation Trust said: “The procedure is very similar to what we have used for many years to treat cancers of the blood and bone marrow. We are not using the therapy as a means of regenerating damaged nervous or other tissues. Instead the procedure is more of an intensive form of “rebooting” the immune system. Across the world over a thousand MS patients have received this treatment, predominantly in continental Europe and North America. International guidelines and recommendations are publically available for patient selection and treatment protocols (www.EBMT.org). Where feasible, patients should be enrolled on clinical trials. The Sheffield team has been working closely with international leaders in this field for several years.”
NHS Blood and Transplant collects the stem cells from patients in their Therapeutic Apheresis Unit using a cell separator machine platform.
Catherine Howell, Chief Nurse of Diagnostic & Therapeutic Services of NHS Blood and Transplant, added: “We are delighted to be supporting this important research and to be working in collaboration with Sheffield Teaching Hospitals NHS Foundation Trust.“
