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HSCT or Hematopoietic Stem Cell Transplant is gaining a lot of attention lately as an effective treatment for Multiple sclerosis, but downsides, side-effects and serious risks are often overlooked.
MS is an autoimmune disorder affecting the central nervous system in which the myelin sheath (insulating covers of nerve cells in the brain and spinal cord) are damaged by person’s own immune system. Basically, the immune system becomes tricked into confusing the myelin sheath as a foreign matter. By doing what the immune system does best - defend the organism against the “foreign” attackers, signals from the brain to the rest of the body become compromised.
So, the creation of HSCT comes from an idea that destroying the old “confused” immune system with chemotherapy and creating a new one using a stem cells transplant, stops the MS activity and progression.
Basically, Hematopoietic Stem Cell Transplant consists of two main stages:
Unfortunately, since it involves the use of chemotherapy:
Not every MS patient is eligible for HSCT. MS patients that are excepted for HSCT must have Expanded Disability Status Scale (EDSS) equal or lower than 6.0. Further on, patients that are older than 40 years of age and had been diagnosed more than 5 years preceding their HSCT had poor treatment outcomes.
Chemotherapy requires an insertion of Hickman line at the start of the treatment. A long silicone tube is inserted into a vein in the neck or under the collar bone that branches into, usually, two or three separate intravenous lines.
The skin gets sore and bruised at the insertion site and is pretty uncomfortable around patients neck and collarbone. It has to be flushed regularly to prevent blood clots from blocking it and cleaned and disinfected to prevent serious infections that HSCT patients (with immune system shutting down) are susceptible to. Hickman line stays in place throughout the treatment, until all of the planned chemotherapy procedures are finished.
Isolation after chemotherapies is something that HSCT patients are often troubled with. Due to non-existing immune system, the patient is vulnerable to a wide variety of bacterial, fungal, viral infections and sepsis and therefore quarantined in the “clean room” without outside contact (no visitation from friends and family). Only a limited number of necessary medical personal have contact with the patient. Depending on the patient’s condition and the speed in which the immune system starts to rebuild itself the isolation lasts for no less than three weeks but in some cases, up to five months and more.
After the discharge from the hospital, follows a period of limited activities and socializing. The immune system gradually rebuilds starting from six months after the treatment, but return to normal activities is not recommended for the next year or 18 months. In the meantime, the patient must be accommodated in the clean environment, avoid crowded places (the body is still prone to infections) and must eat specially prepared food (due to digestive disorders caused by chemotherapies, and low ability to sustain even mild food poisoning). Fruits and vegetables have to be washed thoroughly. Meats, eggs and other animal source food have to be fully cooked (no “rare”, or “medium well” stakes).
For patients that have gone through HSCT and got their immune system “re-set”, the loss of pre-treatment immunity (including childhood vaccination) is inevitable and therefore post-chemo patients are considered as “never vaccinated” resulting in need for specific reimmunization, and some additional necessary vaccination (this includes family members and caretakers that the patient is in frequent contact) not otherwise mandatory for persons with regular immune system
The most serious problem comes with the fact that live vaccines are contraindicated for post-HSCT patients. Live Vaccines:
may be considered only 2 years after the treatment if the immune system recovered and the patient have immunologic response.
Because of the serious risk of cardiomyopathy, chemo-drugs carry a limit on the cumulative lifetime dose (based on body surface area) in MS patients. Therefore HSCT can only be done once. According to trials, HSCT halts or slows-down MS for a few years, and cannot be repeated in a patient’s lifetime, benefits to MS patients are not that great.
Success of the hematopoietic stem cell transplantation treatment vastly varies according to the patient condition and different variant of the treatment – there is no agreed upon standards on details of the treatment. Estimated fatality range due to aggressiveness of chemo is up to 5%. According to available published results of clinical trials it seems that benefits DO NOT outweigh the risks:
MS HSCT PUBLISHED TRIALS
| Trial | Duration | No. of patients | Succeded (no progression) | Failed | Side-effects/fatalities/ |
|---|---|---|---|---|---|
| “Stop MS” | 5 years | 25 | 17 | 8 | Blood cells reduction / infections |
| Canadian trial | 3 years | 24 | 9 | 15 | 1 fatality 1 ICU admission 24 Infection fevers/toxicities |
| Italy | 5 years | 7 | 3 | 4 | No data |
| Nortwestern University |
10 years | No data | 64% | 36% | 7 serious bleeding disorder 7 thyroid disorder |
The main advantages of Swiss Medica stem cells treatment for MS compared to HSCT are:
• Lack of risk and side-effectsSwiss Medica stem cells treatment does not include chemotherapy. Instead, we use a “softer option” – Plasmapheresis, which is a blood filtration system that removes components of the immune system’s antibodies that actually cause the inflammation from the blood stream.
Our doctors will assess each patient’s eligibility based on wide array of factors and possibilities of success. The decision does not exclusively depend on EDSS scale and age of the patient.
Patients can get back to their jobs and everyday activities as soon as day finish the treatment. There is no required period of limited activities and socializing.
Swiss Medica treatment for MS can be repeated as many times as our medical team decides, using various stem cells sources if needed - unlike HSCT
• Swiss Medica treatment does not include just Stem cellsWe use our vast knowledge, equipment and technology to “attack” MS from different directions:
Testimonials
What they say about us
Shaun Lawrence battled multiple sclerosis for many years before deciding to come to Swiss Medica clinic. Limp on his right leg, urinary and bowel problems were some of the main issues he suffered from. After having a stem cell treatment his life changed completely. He is very satisfied with the experience, as well as the overall results of the treatment.
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For me, since I got back after my 2 weeks of having my treatment, within 2 days of being home speaking to friends and family around the world, they all noticed the difference in my speaking, cognitively and I was able to listen and integrate with conversations with my family at home.
A wonderful experience, a wonderful care are these very caring people, yes.
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Everything is done naturally and pleasantly here. Actually I do not feel sick, it is the most important thing – during these 12 days I haven’t felt sick.
I didn’t have the impression that I was treated like a patient. I was treated like a normal person, it is true I take medicines, receive infusions and still have some pain, but I never felt like I was in the hospital.
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Linda Cole struggled with multiple sclerosis for over 30 years. She decided to give stem cell treatment a try, even though she didn’t expect much from it. She was pleasantly surprised, as her symptoms improved and reversed drastically. Her ability to move, walk and think much better than before assured her she made the right decision by coming to Swiss Medica.
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