Can stem-cell therapy halt MS progression at EDSS 6.0?

Question

Hello doctor,

My wife has just been approved for autologous stem-cell therapy for her multiple sclerosis, and we are feeling quite anxious. She has had MS for 12 years and has tried four different medications, but her condition continues to worsen. Her most recent MRI showed three new lesions despite being on Ocrevus. She can barely walk 100 feet without her cane, and her vision has become blurry more frequently.

The neurologist has suggested that stem-cell therapy might help halt the progression of her MS, but warned about serious risks. The procedure involves chemotherapy to wipe out her immune system, which sounds terrifying. Her current EDSS score is 6.0.

We have read that stem-cell therapy tends to have better success in younger patients, but she is already 47. Given her stage, what is the realistic success rate? Additionally, since the treatment is not covered by insurance, we are using our retirement savings to pay for it. Will she need to continue taking MS medications after the procedure? Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

I wanted to share some information about autologous stem-cell therapy (AHSCT involves using a patient's own stem cells, after chemotherapy, to reset the immune system and potentially halt disease progression) and what to consider before moving forward.

Stem-cell therapy:

AHSCT aims to halt the progression of multiple sclerosis (MS is a disease where the immune system attacks the nerves, causing symptoms like weakness, numbness, and vision problems) by resetting the immune system using chemotherapy (a treatment that uses powerful drugs to kill or stop the growth of cancer cells or other abnormal cells). This process involves using the patient's own stem cells to rebuild the immune system after the chemotherapy wipes out the old one. The goal is to stabilize or even improve disability by reducing inflammation and halting the progression of MS.

Risks:

While AHSCT can be effective, it comes with risks, especially due to the chemotherapy involved. Chemotherapy can cause serious side effects, such as infections and complications related to immune suppression. These risks tend to be higher in older patients and those with more advanced MS, but some patients still see positive outcomes, particularly if they have active disease.

Effectiveness at age 47:

Although younger patients tend to have better outcomes with AHSCT, patients in their 40s can still benefit significantly from the therapy. Studies show success rates of around 70 to 80 percent in halting disease progression or improving symptoms, even for those over 40.

Post-treatment medications:

After AHSCT, some MS medications may no longer be needed, as the treatment could reset the immune system. However, ongoing monitoring and symptom management may still be necessary to address any residual symptoms or complications.

Financial considerations:

Since AHSCT is not covered by insurance, it is a substantial financial investment, often requiring out-of-pocket payments. It is important to weigh the potential benefits of halting progression against the financial burden and risks, and discussing these factors with her healthcare team is crucial in making an informed decision.

I hope this helps.

Please revert in case of further queries.

Thank you.