Stem cell treatment raises hope for multiple sclerosis patients

As there is no established cure for multiple sclerosis (MS) yet, doctors and patients are pinning hopes on stem cell transplantation with an interim global study showing that the treatment is found to be effective to halt the degenerative disease that affects the brain, spinal cord and immune system, leading to a number of disabilities.

Currently, there are 23 lakh patients living with MS worldwide. In India, the number is estimated to be between one lakh and two lakhs. It is an autoimmune disease which has no known cause or cure.

Dr Kameshwar Prasad, professor and Head of Neurology Department and his team of experts at All India Institute of Medical Sciences (AIIMS) here are much optimistic about the interim results of the stem cell treatment for the MS which were shared at the much touted meeting of the European Society for Bone and Marrow Transplantation in Lisbon in March.

Dr Prasad said that initial results from the clinical trial run from four international centres has shown that wiping out the patients’ immune systems with chemotherapy, and restoring them with the new stem cell treatment, appears to halt the disease and improve symptoms.

“We are hopeful of the results — they are a game-changer for patients with drug-resistant and disabling MS,” he said even as he noted that these were interim analysis. Participants are due to be followed up for 5 years after treatment. 

The treatment, called autologous haematopoietic stem cell transplantation (HSCT), was trialed in a group of 100 patients with relapsing remitting MS — the most common form of the disease.

So far, on an average participants have been followed up for 3 years from starting treatment. Treatment failure was 6 per cent (3 of 52) for AHSCT and 60 per cent (30 of 50) for DMD.  For the 30 DMD participants who switched to AHSCT, at one year after stem cell treatment, the average EDSS improved from 5.2 to 2.6.

Keen to conduct SCT research in the sector, the AIIMS doctors too had submitted a proposal to the Department of Bio Technology (DBT) under the Union Science and Technology Ministry for the research in the sector. However, after sitting over it for the last many years, it has now rejected the proposal. “We wanted to conduct an advance stem cell research for MS using either autologus hematopoetic stem cell transplantation or mesenchymal stem cell therapy. Presently, we are doing SCT on individual cases after taking approval from the ICMR.

Talking about the drugs available for MS patients, he said, “Prior to 1994, we had drugs only axerpirithen, but now atleast 15 drugs have been approved by the USFDA and other developed nations. But the main problem is that these are very costly-from three lakhs to two crores. Azathropiine which is generic costs a patient Rs 10 thousand per year,” he said.

Dr Rohit Bhatia Professor at Department of Neurology at AIIMS talked about the registry for patients suffering from MS to understand the demographic and clinial profile and risk factors involved.

He also talked about a recently published AIIMS study involving 101 patients at the hospital between 2011 and 2012 that found that 68 per cent of them suffered from relapsing remitting MS, while rest of the cases being progressive in nature.

Dr MV Padma Srivastava, Professor of Neurology at AIIMS, stressed on early diagnosis to ensure early treatment for quality life. Studies suggest that genetic risk factors increase the risk of developing MS, but there is no evidence that MS is directly inherited. Environmental factors, such as low Vitamin D and cigarette smoking have also been shown to increase the risk of MS, she added.

MS is unpredictable and can cause symptoms such as extreme fatigue, lack of coordination, weakness, tingling, impaired sensation, vision problems, bladder problems, cognitive impairment and mood changes, causing physical, emotional and financial drain on the patients.