MS Answers

Answered on: 3/6/2007

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Q :

Dr. Freedman is overseeing the stem cell transplantation project. To date, it has been reported that those on the trial (apart from the sad death of one participant) have stabilized and that one woman with relapse-remitting MS has shown remarkable improvement. Is stem cell transplantation likely to become a standard treatment? How might this project advance our understanding of the mechanisms driving the damage in MS?

A :

It is true that no patient thus far has had either a relapse or evidence of new MRI lesions and all seem to have remained fairly static with regards to their EDSS going out now 5 years plus, but it is highly unlikely for this treatment to become mainstream for MS. Not only is the whole treatment costly and risky but it is still considered to be experimental. In a highly selected group of patients it might become a consideration.

As to how it will enlighten us about MS, it is important to first understand what is unique about these patients. By the time we make a diagnosis, most patients have had their illness for some time, so figuring out what ‘kick-starts’ the disease is near impossible. In order to do this, we must look at a time when the disease begins. This is what we were intending to do in our patients after wiping out the old immune system and watching the new one renew, presumably with the disease. In effect, we did not believe that the treatment would completely stop the disease. However, watching the immune system re-develop in patients may give us a clue as to what may have gone wrong to begin with. We are comparing some of the immune aspects prior to the transplant with those afterwards to see what changes take place that might account for the well-being of patients following the treatments. We also recognize today that inflammation can be both good and bad. In MS, especially the patients enrolling in this study, it is clear that there is an imbalance of inflammation with the ‘bad’ type dominating. The transplant procedure wipes out both types, but upon recovery, the immune system seems to only be capable of ‘good’ inflammation. Understanding how to identify this type of inflammation may be key to earlier less toxic types of treatment

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DISCLAIMER: Please be aware that this information does not necessarily represent the opinion of the MS Society of Canada, and is not intended as medical advice. For specific advice and opinion, always consult a physician.