| Mesenchymal Stem Cell Therapy | Immunoablation and Autologous Hematopoietic Stem Cell Transplantation |
Who can access this therapy? | This therapy is experimental, and is only available through participation in the MESCAMS clinical trial.
This trial can only accept patients (aged 18 to 50) with relapsing-remitting MS in whom at least one of the existing therapies has not thoroughly contained disease activity, as well as those with secondary and primary progressive forms of MS that continue to have active disease activity.
For detailed inclusion and exclusion criteria, see trial NCT02239393 at ClinicalTrials.gov. (See "How can I participate?", below) | This therapy is used only for patients with aggressive (but still early) forms of MS in whom existing therapies have not thoroughly contained disease activity. People with MS who have had significant disability for a long time would likely not benefit.
The Ottawa Hospital has performed a clinical trial of this treatment (summarized at ClinicalTrials.gov in trial NCT01099930), which has now been completed. The results are available here.
This treatment is currently available for appropriate patients. (See "How can I participate?", below) |
What type of stem cell is used and how do these cells work? | This procedure uses Mesenchymal Stem Cells, which are also called Mesenchymal Stromal Cells or MSCs. These cells can be found in adult bone marrow, fat and skin tissue, as well as umbilical cord blood. Although they can give rise to other cell types, their therapeutic potential seems to come more from their ability to modify the immune system (i.e. reduce inflammation) and release factors that help prevent and repair tissue damage. | This procedure uses very high doses of chemotherapy and antibodies to eliminate the defective immune system. A new immune system is regenerated from Hematopoietic Stem Cells, or HSCs. These cells can be found in adult bone marrow and blood, as well as umbilical cord blood, and they can give rise to all of the cells that make up the blood and immune system. The new immune system no longer attacks the brain and spinal cord. |
What does the procedure involve? | MSCs are extracted from the patient’s own bone marrow and expanded over several weeks in a specialized culture laboratory. The MSCs are maintained frozen, and later thawed, then infused back into the same patient, intravenously. | The first step is to obtain the cells capable of replacing the defective immune system. Using chemotherapy and a stimulating drug, the patient’s own HSCs are mobilized from the bone marrow into the bloodstream where they are extracted and purified in a specialized laboratory and then frozen. The patient then receives strong chemotherapy to completely eliminate their existing, defective immune system. Then they receive an intravenous infusion of their previously frozen HSCs, which expand in the body to give rise to a new immune system that no longer attacks the brain and spinal cord. This is a complex treatment with significant side effects (patients should discuss this in detail with their neurologist). |
Where else is this procedure available? | This procedure is also available at Health Sciences Centre Winnipeg through the same MESCAMS trial. The international arm of this trial (called MESEMS) is also accepting patients in Europe and elsewhere. Patients can search for other clinical trials at ClinicalTrials.gov.
Note that CloserLookatStemCells.org provides a list of signs to look for and questions to ask when researching stem cell therapies. | Other specialized bone marrow transplant centres may offer this procedure. Patients should consult with their own neurologist for more information. |
Are there any residency requirements? | The MESCAMS trial at The Ottawa Hospital will only accept residents of Canada with valid health insurance (OHIP or equivalent).
Participants from outside Ottawa will be requested to relocate to the area for the duration of the trial (approximately one year). | Patients must have valid Canadian health insurance (OHIP or equivalent). Patients must reside close to Ottawa for a time, and then must reside close to a major health-care facility familiar in the monitoring required following this type of treatment. |
How can I participate? | The first step is to discuss this option with your own neurologist. If your neurologist, after reviewing the inclusion and exclusion criteria (available at ClinicalTrials.gov – trial NCT02239393), believes that you might be a good candidate for this procedure, he or she can send a referral to The Ottawa Hospital MS Clinic for consideration. | The first step is to discuss this with your own neurologist. If your neurologist believes that you might be a good candidate for this procedure, he or she can send a referral to The Ottawa Hospital MS Clinic for consideration. |
