Stimulate the growth of white blood cells in your bone marrow.The first thing you will need to do in order to treat MS via chemotherapy is to stimulate the growth of white blood cells so that a large enough sample can be removed from your body and stored (frozen) for use later on.,
Receive chemotherapy for your MS.Chemotherapy is traditionally thought of as a treatment for cancer only; however, it is also effective in destroying white blood cells, and it is a certain lineage of white blood cells (called your T cells) that are responsible for the autoimmune damage in multiple sclerosis.,
Continue with regular monitoring following the chemotherapy.Your cell counts will typically return to normal 9-14 days following the treatment.,
Have the stem cell transplant.Once your white blood cells have been wiped out with chemotherapy, you are now ready to receive the autologous (meaning using your own cells) stem cell transplant.,
Determine whether you are a candidate for chemotherapy.In order to be a candidate to receive chemotherapy treatment for your MS, you need to have a form of MS with a poor prognosis (meaning a poor outlook moving forwards).,
Talk to your doctor about how to sign up for an MS clinical trial.,
Factor in the risks of MS chemotherapy treatment.Over 90% of people who have received this treatment to date have suffered no serious complications from it.,
Learn about the various MS treatment options that are available, apart from chemotherapy.While MS cannot be cured (and medical researchers are still actively looking into the question of how best to treat it), there are several options available to treat and improve symptoms and, in some cases, to actually slow the progression of MS as well.,
Consider steroid treatment.Regardless of which type of MS you have, and how early or late it is in the course of your disease, virtually all MS patients are offered steroids as a form of treatment.,
Opt for “plasma exchange.,
Ask your doctor about treatments for symptom management.Common symptoms of MS include fatigue, trouble with bladder control, muscle stiffness and/or spasms, sensations of numbness and/or tingling, vision problems, trouble walking, problems with balance and/or coordination, and decreased cognitive function (problems with thinking, learning, and planning).,
Try specific “disease-modifying” therapies.As previously mentioned, the only way to actually alter (i.e.
The chemotherapy is the initial part of this treatment, and it must be followed up by a stem cell transplant, which is what these cells that are frozen will be used for down the road.
You will likely receive a medication such as G-CSF (Granulating Colony Stimulating Factor) which will promote the growth of white blood cells, that can subsequently be removed and frozen.
After this preparation stage is complete, you will be ready to move forward with chemotherapy.;
, Therefore, using chemotherapy to target and “kill off” your white blood cells, including your T cells, can be used as a method to get rid of the cells that are at the root of the problem in MS. It is this concept that has made the idea of chemotherapy for MS potentially so promising (although it is still in the early stages so doctors have yet to see ongoing proof of its effectiveness).
Chemotherapy agents that are typically used include a combination of Etoposide, Cytarabine, Carmustine, and Melphalan, as well as an immunosuppressive agent called Thymoglobulin. The chemotherapy regimen is called “BEAM.”
Although chemotherapy does not technically cure MS, 18 out of 19 patients in the initial study showed either a stabilization or an improvement of their disease following treatment – so it is certainly a promising option for those who meet the eligibility requirements., However, you will be required to continue with ongoing monitoring for approximately 2 months following chemotherapy treatment for MS.
In the initial 2-month period following chemotherapy, doctors will check your cell counts and overall response to treatment to ensure that there are no complications.
You will also be asked to follow up with 8 study visits over the course of the following 5 years. At these visits, doctors will examine your blood and your urine, they may do an MRI, and they will perform a neurological exam to assess your MS symptoms (and to note the hopeful improvement of your symptoms since receiving treatment).
These follow up visits serve to inform you about your progress, as well as to provide the data needed for the study to determine the long-term efficacy of MS chemotherapy treatment.
, This is the final stage of treatment. The hope is that the chemotherapy will have eliminated all of the damaging T cells from your white blood cell line that were responsible for the autoimmune damage of multiple sclerosis. The goal now is to replace the cells that were destroyed with healthy new cells (the ones that were frozen and will now be transplanted).
When the cells were frozen, the doctors will have removed the T cells, and frozen only healthy cells to be transplanted back into you following chemotherapy. This is what makes the treatment so effective and so promising.
You will remain in hospital following the stem cell transplant until your “peripheral cell counts” (your white blood cell counts) have returned to the normal range., It is generally not used to treat mild cases of MS, due to the lack of evidence and the potential risks. If you have a severe progressive form of MS, or one with multiple relapses, this treatment may be for you.
If your form of MS qualifies for potential chemotherapy treatment, your doctor will also need to evaluate your overall health and fitness to receive the treatment.
If you have a number of other medical illnesses, you may not be eligible. However, if your body is strong and healthy, you may be eligible to participate in the clinical trial and to receive chemotherapy as a treatment for your MS.
, It is important to understand that chemotherapy as a treatment for MS is still in the clinical trial phase.What this means is that it is a new treatment that has only recently been tried by the medical community, and it lacks substantial long-term evidence of its effectiveness.
Normally, you would speak to your doctor to determine your eligibility to enter the clinical trial and, if you qualified, he or she would put you in contact with the physicians administering the trial.
Unfortunately, the clinical trial for MS chemotherapy is not currently accepting new patients.It may or may not open again down the road for new patients.
If chemotherapy treatment remains of interest to you, continue to follow up with your doctor about the status of the clinical trial to see if any new spots open down the road.
, However, there have been a few case reports of people who have died from the treatment. Also, there is no long-term evidence yet as to potential implications of the treatment on your health and wellbeing down the road. It is important to be aware of the risks prior to signing up for this novel treatment.
If your condition is severe enough (i.e. if you are suffering a lot from your symptoms of MS), the benefits of trying the treatment will likely outweigh the cons.
However, it is up to you to weigh the pros and cons and to determine which choice is right with you. Your doctor can provide guidance and assistance with this decision.
, Whether or not the progression is able to be slowed depends on two factors:
The stage at which “disease-modifying treatment” is initiated (the earlier, the better), and
The specific type of MS you have. The “relapsing-remitting” type tends to be the one which responds best to disease-modifying treatment, which in turn can slow the rate at which it progresses.
, Examples of steroid medications include Prednisone and IV (intravenous) Methylprednisolone. The purpose of steroid therapy is to reduce the inflammation around the nerves, as it is an autoimmune attack of the nerves that leads to the symptoms of MS to begin with.
,”Another option, if steroid therapy does not help you, is plasma exchange (called “plasmapheresis”). This is when a portion of your blood (the plasma) is removed and exchanged with new plasma. The goal is that, in the exchange, the autoimmune antibodies (leading to the symptoms of MS) can be temporarily cleared from your body.
, Many of these symptoms can be improved with specific medical treatment.
, slow) the progression of the disease itself is to opt for disease-modifying therapies. These are most successful for the relapsing-remitting form of MS. They have unfortunately shown little utility in the other forms of MS.
Treatment options include Beta interferons, Dimethyl fumarate, Teriflunomide, Natalizumab, Glatiramer acetate, Fingolimod, Mitoxantrone, and Alemtuzumab.
These treatments may have significant side effects, so it is important to discuss the pros and cons with your physician prior to initiating treatment.