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Lancet study on stem cell transplants for MS promising

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  • Lancet study on stem cell transplants for MS promising

    News of the below study has been burning up my inbox. The link is to the LA Times story and below that is the press release from The Lancet. These developments, while not new (stem cell transplants have been going on in Costa Rica and other countries for some time), bode well for our future with this disease. - Dave

    Stem Cell Transplantation Can Stabilise, Reverse Neurological Disability in Patients With Relapsing-Remitting MS

    NEW YORK -- January 29, 2009 -- A study of 21 adults with relapsing-remitting multiple sclerosis (MS) has found that autologous nonmyeloablative haemopoietic stem cell transplantation can stabilise, and may reverse, neurological disability. The findings of this phase 1/2 study are published early online and will appear in the March print issue of The Lancet Neurology.

    Richard K. Burt, MD, Northwestern University Feinberg School of Medicine, Chicago, Illinois, and colleagues assessed the safety and clinical outcome of this transplantation technique in 21 patients (11 women, 10 men) with relapsing-remitting MS who had not responded to at least 6 months' treatment with interferon beta.

    By contrast with previous studies of autologous haemopoietic stem cell transplantation in MS, the participants in this study were young (average age 33 years; range 20-53), were in the relapsing-remitting phase, and did not have severe disability. The participants had had MS for an average of 5 years.

    The researchers used a nonmyeloablative conditioning regimen. The first 17 patients received cyclophosphamide and alemtuzumab, and the other 4 received cyclophosphamide and rabbit antithymocyte globulin.

    After an average follow-up of 3 years, 17 patients (81%) improved by at least 1 point on the Kurtzke expanded disability status scale (EDSS). No patient had a final score on the scale that was lower than their score before transplantation.

    In addition to the improvements in neurological function noted during the study, the procedure was well tolerated. One patient had diarrhoea due to a bacterial infection, 2 had viral infections, and 2 patients developed thrombocytopenic purpura related to the conditioning treatment they received. All of these events resolved with treatment. Of the patients, 5 relapsed, but achieved remission after receiving other immunosuppressive therapy.

    Although further studies are needed, "autologous nonmyeloablative haemopoietic stem cell transplantation for patients with relapsing-remitting MS with active inflammatory disease and frequent exacerbations is a feasible procedure that not only seems to prevent neurological progression, but also appears to reverse neurological disability," the authors concluded.

    SOURCE: The Lancet Neurology
    Dave Bexfield