Autologous Hemotopoietic Stem Cell Transplant and Multiple Sclerosis

Here is My Question:
Hi, so, there have been reports of Selma Blair having had a stem cell transplant and she is in remission. Is this something that could assist other Multiple Sclerosis patients? And where would one start to seek out information on this option.

Answer:
Selma Blair underwent a procedure called an autologous hematopoietic stem cell transplant at Northwestern university using a protocol similar to the protocol we use at UCSD. It is a procedure with more short- and long-term risks and side effects than currently approved high efficacy disease modifying therapies. To be a candidate one must meet the following criteria

1. Be under the age of 45 and preferably under the age of 40
2. Only relapsing remitting people with MS (no progressive disease) with recent activity (verified relapses or MRI activity) in the prior 2-years despite at least 2 disease modifying therapies 
3. Must be ambulatory for at least 50 meters (about half the length of a football field)

The procedure involves 4 steps:

1. We collect your hematopoietic stem cells using a procedure called leukapheresis. we stimulate the release of these cells into your blood stream by giving you cyclophosphamide, a chemotherapy
2. We give you a large dose of chemotherapy to destroy your remaining lymphocytes.
3. We give you back your stem cells. These cells migrate to the bone marrow and other immune organs to reform your adaptive immune system
4. We give you an additional monoclonal antibody called anti-thymocyte globulin to destroy any mature lymphocytes mixed in with the stem cells just infused

The Procedure requires admission to the bone marrow transplantation unit for 10-14 days. People remain severely immunosuppressed for up to 100 days after the procedure.

Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego