Does AHSCT work for progressive MS?
Sometimes it does although it seems to work well only if your MS has a mix of progression with inflammatory activity.
AHSCT (also known as ASCT or HSCT) uses your own haematopoietic stem cells collected from your blood. They are put back into your blood stream after your immune system has been largely wiped out with chemotherapy drugs. The idea is that the immune system is rebuilt in a way that slows down or stops MS disease activity.
AHSCT has been tested more than any other kind of stem cell therapy for MS. It has been tried in people with all types of MS but works better for some than others. Those who are helped the most are people who have inflammation as part of their MS. This generally means having active lesions on MRI scans or continuing relapses despite treatment with disease modifying drugs. This group includes many people with relapsing MS but also a small number with progressive forms of MS. This is an important point – whether AHSCT is likely to work is about whether there’s ongoing inflammation, or not, rather than the type of MS. Having said that, I need to emphasise that not many people with progressive MS have inflammation so the numbers who might benefit from AHSCT, in its current form, are going to be small.
ACTiMuS – a clinical trial for progressive MS
If you don’t have active inflammation and damage has already been done, another approach will be needed. There are research teams around the world developing different stem cell therapies and the outlook seems good. I’ll talk about one example.
The ACTiMuS clinical trial, part funded by the MS Trust, is testing a kind of stem cell therapy for people with progressive MS. It uses a type of stem cells called mesenchymal stem cells which are harvested from the person’s own hip bone marrow then reintroduced to their blood stream. The idea is that the stem cells will work to protect nerve cells from damage and encourage the repair of existing damage. This approach to cell therapy does not need aggressive chemotherapy and so has far fewer risks than AHSCT. A pilot study to check the safety of the procedure went well so the ACTiMuS trial is now testing this approach in more people with MS (this trial is already in progress and the researchers are not looking for more participants).
What does the future look like?
I’ve only looked at a couple of examples in this blog but there is every reason to hope that stem cell therapy will become more widely available, including for people with progressive MS.
The MS Trust is committed to making this happen. We are funding a group in London to conduct the first ever audit of a real-world UK MS stem cell service run outside a clinical trial. From this audit, the researchers hope to understand how people with MS can be assessed and selected for stem cell treatment, and what is needed to develop safe, high quality services for the future. That way, the right people should be offered AHSCT and those who won’t benefit will be spared a lengthy, sometimes painful and relatively risky procedure. You can help to fund this important work by making a donation.
The MS Trust is one of the funders of the ACTiMuS clinical trial which is focussed on developing an effective stem cell therapy for people with progressive MS. This is part of the worldwide commitment by MS researchers to develop stem cell therapies that could work for people with progressive MS.
We will let you know the results of research into stem cell therapy through our website, our email alerts and our newsletter, Open Door. You can keep in touch with the MS Trust andhelp us to continue our work supporting everyone living with MS.