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Looks like pretty good results for progressive MS -- 77% either stable or improved over 4 years after the procedure.



Clinical outcomes after autologous haematopoietic stem cell transplantation in patients with progressive multiple sclerosis.

Chin Med J (Engl). 2006 Nov 20;119(22):1851-5.
Xu J, Ji BX, Su L, Dong HQ, Sun XJ, Liu CY.
Department of Haematology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053, China (Email: xujuandail@x263.net).

BACKGROUND: Multiple sclerosis (MS) is a continuously disabling disease and it is unresponsive to high dose steroid and immunomodulation with disease progression. The autologous haematopoietic stem cell transplantation (ASCT) has been introduced in the treatment of refractory forms of multiple sclerosis. In this study, the clinical outcomes followed by ASCT were evaluated for patients with progressive MS.

METHODS: Twenty-two patients with secondary progressive MS were treated with ASCT. Peripheral blood stem cells were obtained by leukapheresis after mobilization with granulocyte colony stimulating factor. Etoposide, melphalan, carmustin and cytosine arabinoside were administered as conditioning regimen. Outcomes were evaluated by the expanded disability status scale and progression free survival. No maintenance treatment was administered during a median follow-up of 39 months (range, 6 to 59 months).

RESULTS: No death occurred following the treatment. The overall confirmed progression free survival rate was 77% up to 59 months after transplantation which was significantly higher compared with pre-transplantation (P = 0.000). Thirteen patients (59%) had remarkable improvement in neurological manifestations, four (18%) stabilized their disability status and five (23%) showed clinical recurrence of active symptoms.

CONCLUSIONS: ASCT as a therapy is safe and available. It can improve or stabilize neurological manifestations in most patients with progressive MS following failure of conventional therapy.

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

Peripheral blood stem cells were obtained

ooo... that sounds good. I always thought autologous stem cells involved bone marrow. A very painful experience from my understanding.

by leukapheresis after mobilization with granulocyte colony stimulating factor. Etoposide, melphalan, carmustin and cytosine arabinoside were administered as conditioning regimen.

Hmmm.. .this is the bit that probably hurts...

ASCT as a therapy is safe and available.

Where do i sign up? why is there not more of this going on?

Good question. I think it could be that a lot of doctors want to see a huge pile of safety data because of the deaths that happened in the earliest trials of this procedure in MS. Something I read recently said that there haven't been any deaths from autologous stem cell tranplant for MS since 2003, so it looks like they are figuring out how to reduce the risk somewhat. There are a bunch of ongoing trials right now too, so it looks to be almost ready for prime time.

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I didnt read/understand the bit where they were killing off your current immune system. Is this what this all meant?

Etoposide, melphalan, carmustin and cytosine arabinoside were administered as conditioning regimen

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Ok, so I looked up the word haematopoietic. But came accross the following.

Recent reports suggest that haematopoietic stem cells can transdifferentiate into unexpected phenotypes such as skeletal muscle, hepatocytes, epithelial cells, neurons, endothelial cells and cardiomyocytes, in response to tissue injury or placement in a new environment.

However, this study found that:

These results indicate that haematopoietic stem cells do not readily acquire a cardiac phenotype, and raise a cautionary note for clinical studies of infarct repair.