MS has been the subject of prime time telly in Britain this week, with current affairs programme Panorama covering the stories of patients who have been amongst the first to undergo a crossover cancer treatment which they say has reversed serious symptoms of MS, including paralysis, in some of them.
Stem cell transplantation
The treatment is a type of stem cell therapy (autologous haematopoietic stem cell transplantation, or AHSCT) which in theory essentially rebuilds the immune system, and has until now been largely used to treat cancers of the blood and bone marrow.
It works by administering chemotherapy drugs to ablate or destroy the immune system, which is then regenerated using the patient’s own stem cells which were harvested prior to the chemotherapy.
It’s believed that in instances of MS, the ‘rebooted’ immune system will no longer be capable of causing the damage which otherwise occurs.
Featured in the program, Professor Basil Sharrack, one of the professors behind this stem cell transplantation, clarifies that the treatment is not effective in patients with primary or secondary MS, nor for those with relapsing-remitting MS who have had the condition for more than 10 years.
It is important, he says, to realise that this treatment can’t actually ‘rebuild’ the nerve cells, therefore won’t help those who already have nerve damage.
Rebooting the immune system
Professor John Snowdon describes the treatment as “more of an intensive form of "rebooting" the immune system.”
Others believe that the improvements seen are probably due to the immune response being switched off temporarily, allowing the body time to repair itself and help restore lost function.
Some modern disease-modifying drugs, such as mitoxantrone, can produce similar results in the absence of any stem cells being involved, by temporarily turning the disease "off" as it were.
AHSCT is an aggressive treatment with a long recovery time, including periods in isolation, and the results for the MS patients who have taken part in the clinical trials have been mixed.
Some patients have seen no improvement in their condition, however some experienced either stability in their disability or, in the most successful cases, an overall improvement.
So aggressive is this treatment that it is not routinely available. Aside from clinical trials, only a handful of patients have undergone AHSCT in the UK, and this would have been due to their conditions being both rapidly progressive, and non-responsive to any other treatment.
It is important to remember that this treatment has very serious side effects, including death in around 1.5-6% of cases.
Professor Jelinek's opinion
Asked to comment on AHSCT and its coverage in the press recently, Professor Jelinek agrees that some people will have such seriously and rapidly progressive disease that they may require such heavy-hitting medical approaches to get control over the illness.
However for most, he says, the OMS Recovery Program should provide the ability to stabilise the illness and improve without enduring the very toxic side effects of such treatment.
Even those who adopt aggressive medical therapies such as chemotherapy, he adds, should take sensible preventive medicine approaches to controlling the illness, such as the OMS Recovery Program.