Stem Cell Transplantation and MS

Question:  The TISCH MSRC has started a Phase I trial for SPMS doing autologous BMT. Are there any there other centers that are involved in this research?

Answer:  Stem cell transplantation procedures for inflammatory disorders like MS come in several flavors:

1. The oldest type is simply a bone marrow transplant. To my knowledge this is no longer done, which is good since bone marrow aspirations are painful.
2. There are two main types of autologous stem cell transplantation procedures currently in research studies (I do not know of anyone currently doing allogeneic transplants which requires cells derived from a matched donor and prolonged immunosuppression after transplantation to avoid rejection and graft vs host disease). The key to both types is the requirement of collecting adult stem stem cells from the patients blood circulation after stimulating these cells to be released into the blood stream in large numbers. The first type requires total ablation of all bone marrow derived cells by high dose chemotherapy before re-injecting the patient with their collected stem cells. The re-injected stem cells must then re-populate the bone marrow to create the immune system, red blood cells and platelets required for life. The second type is identical but the bone marrow ablation procedure only eliminates bone marrow derived lymphocytes and spares the cells that make platelets and red blood cells. This procedure is theoretically safer.  These autologous stem cell transplantation procedures are being done at the University of Washington Western MS Center (Seattle), Ohio State University, Baylor,Northwestern University and the TISCH MS Center in New York to name a few centers. This information may be slightly outdated but updated information is available at the clinicaltrials.gov website. This website may also list other sites doing stem cell transplantation research.
3. The third type of stem cell transplant is called a mesenchymal stem cell transplant. These have become very popular in recent years particularly in Europe. Mesenchymal stem are readily collected from the blood but must be stimulated to proliferate and grow in culture outside of the body to create large enough numbers for transplantation. This procedure does not require risky chemotherapy with ablation of the bone marrow and presumably has a different mechanism of action, if it works at all. There are many private clinics claiming to provide this type of stem cell transplant, but they do not grow and stimulate the cells outside of the body prior to transplantation; it doubtful that this procedure would be of any benefit other than robbing you of hard earned income.  There are several preliminary research studies of mesenchymal stem cell transplantation underway with the main US study at the Cleveland Clinic Foundation (Dr Jeff Cohen is the PI).
   

All of these procedures are still considered experimental and can not be recommended at this time.

Rip Kinkel