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Saturday, February 27, 2016

Stem Cell Transplant in Multiple Sclerosis: Next Steps

Caroline Helwick
February 26, 2016

NEW ORLEANS — Could stem cell transplant emerge as a reliable treatment for both relapsing and progressive forms of multiple sclerosis (MS)? Experts believe so, and they hope to prove it in clinical trials.
Andrew Goodman, MD, professor of neurology and director of the Multiple Sclerosis Center at the University of Rochester Medical Center in New York, led a discussion on the topic of stem cell transplant in MS at Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2016.
He began his presentation with a headline from The Economist(January 23, 2016): "Curing Multiple Sclerosis: Stem Cells Are Starting to Prove Their Value as Medical Treatments."
"Be aware," he said, "that this is a topic that is much in the public's mind."
The article focused on hematopoietic stem cell transplantation (HSCT), which, as he explained, is more about the reconstitution of the immune system after immunoablation than it is about the stem cells themselves. While the therapeutic element of HSCT is not actually the stem cells, "in the public's mind, that's stem cell therapy," he commented.
Other more "biologically correct" cell-based strategies are being evaluated in progressive MS, he said.
Desperate Patients
Patients with MS routinely ask about stem cell transplant, and many are hoodwinked by centers making outrageous claims, several experts noted during the session.
"Many patients come to me saying they have 'been approved' for a transplant and ask if they should go. I say, 'Approved to give them $20,000?' These are clinics with very slick websites claiming to cure everything," said Michael K. Racke, MD, professor of neurology and neuroscience at Wexner Medical Center at The Ohio State University in Columbus.
Benjamin Segal, MD, the Holtom-Garrett Professor of Neurology and director of the Multiple Sclerosis Center at the University of Michigan Medical School, Ann Arbor, added in an interview with Medscape Medical News, "Every time I'm in clinic I am asked about stem cells. There are private companies out there that exploit desperate people."
"One of my patients with progressive MS went to Germany to get some type of intrathecal embryonic stem cell injection," Dr Segal said. "A few months later, her husband informed me that she developed meningitis as a complication, and she died."
Dr Racke, Dr Segal, and other MS experts at the meeting voiced optimism, though, that research is moving in the right direction, and that stem cell transplant will some day become a treatment that professionals can embrace.
General Issues Yet to Be Settled

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