Re: Spring 2016 | Page 41

Can Stem Cell Therapy help MS sufferers? now I can swim and cycle and I am determined to walk”. His treatment has been reviewed, and like Holly, there was no evidence of active disease. The Royal Hallamshire Hospital, together with hospitals in the United States, Sweden and Brazil, is part of an international trial, known as MIST, which is assessing the long term benefits of the stem cell transplant. Around 100,000 people in the UK have Multiple sclerosis (MS), an incurable neurological condition. Most patients are diagnosed in their 20s and 30s. MS affects nerves in the brain and spinal cord, causing a wide range of symptoms including problems with muscle movement, balance and vision. Each nerve fibre in the brain and spinal cord is surrounded by a layer of protein called myelin, which protects the nerve and helps electrical signals from the brain travel to the rest of the body. In MS, the disease causes the immune system to attack the myelin which becomes damaged. The damaged myelin disrupts the nerve signals. If the process of inflammation and scarring is not treated then eventually the condition can cause permanent neurodegeneration. UK doctors at Sheffield’s Royal Hallamshire Hospital have been treating MS patients with bone marrow transplants using their own stem cells. The 20 patients treated showed remarkable results. The treatment, known as an autologous haematopoietic stem cell transplant (HSCT), aims to destroy the faulty immune system using chemotherapy. It is then rebuilt with stem cells harvested from the patient’s own blood. These cells are at such an early stage they’ve not developed the flaws that trigger MS. Stem cells are so effective because they can become any cell in the body based on their environment. The BBC’s Panorama programme which aired in January was given exclusive access to several patients who have undergone the stem cell transplant. Holly Drewry was just 21 when she was diagnosed with MS and her condition deteriorated after she gave birth to her daughter. Holly received her treatment at Sheffield and said “I started seeing changes within days of the stem cells being put in”. Holly had needed a wheelchair before her transplant but after the treatment she was able to walk out of hospital. Holly describes it as a miracle. Holly’s treatment has now been reviewed and her condition has been found to have been dramatically halted. She will still need to be monitored but the hope is that the transplant will be a permanent fix. For other patients the results have been equally dramatic. Steven Storey was a marathon runner and triathlete before he was stuck down by the disease and left completely paralysed. He said “At one point I couldn’t even hold a spoon and feed myself”. Within nine days of the treatment Steven was able to move his toe and within 10 months he managed a mile long swim in the Lake District. Steven still requires a wheelchair but is astounded at his progress “It’s been incredible. I was in a dire place, but All of the patients on the trial have relapsing remitting MS where patients experience attacks followed by periods of remission. The treatment involves intensive chemotherapy so patients are warned that there are side effects such as nausea and hair loss. The transplant involves a one off cost of around £30,000 which is comparable to the yearly cost of some MS treatments. The procedure involves no new drugs and instead repurposes an existing therapy using the patient’s own cells. Consequently there is little profit incentive for drug companies to get involved. Professor Richard Burt of Northwestern University, Chicago carried out the first HSCT as long ago as 1995 and is coordinating the international trial which began in 2006. He said “There has been resistance to this in the pharma and academic world. This is not a technology you can patent and we have achieved this without industry backing”. The outcome of the more detailed MIST trial is not expected for a few years and could determine whether the stem cell transplant becomes a standard NHS treatment for many MS patients. The BBC Panorama programme made clear that stem cell therapy is still very experimental and is not suitable for everyone. However, it could potentially be a very effective therapy, holding great promise for people living with MS. It’s a long way from being a routine treatment for MS and more clinical trials are needed to understand who is most likely to benefit from treatment and fully understand what the long-term effects of treatment might be. By Annika Mason 41