Stem Cell Transplant

What are Stem Cells?

Stem cells are cells which are able to differentiate into other types of cells and are capable of ‘self-renewal’ or multiplying to produce greater numbers. Stem cell treatments are any therapies which target or use stem cells – usually to replace or repair damage.

What is Stem-Cell Treatment?

Stem cell therapy is any treatment that uses or targets stem cells. This is usually to help replace or repair damaged cells or tissues, but can also be used to prevent damage from happening in the first place.

Autologous Haematopoietic Stem Cell Transplant (aHSCT – Stem cell treatment)

Multiple Sclerosis is an autoimmune disease where the body’s own immune system attacks the myelin sheath around the nerves in the brain and spine. This interrupts messages sent by the brain to the rest of the body and impacts arm and leg function, bladder and bowel functions and cognition.

The aim of aHSCT is to “reset” the immune system, so that it will stop attacking the person’s own myelin sheath. aHSCT has traditionally been used for the treatment of life-threatening cancers. Trials for MS have been taking place for over 15 years. Some of the scepticism surrounding aHSCT is due to the early transplants raising a number of concerns about the safety and efficacy with several long term of life threatening complications. However more recent trials have defined clear criteria for PwMS who are most likely to benefit. In addition there has been greater emphasis on safety and efficacy.

Process of aHSCT

AHSCT is an aggressive treatment which has been used for over 20 years for the treatment of some cancers. It involves a number of steps, including:

Collecting or ‘harvesting’ stem cells from the bone marrow or blood of the patient
Purifying and concentrating the stem cells in the laboratory
Freezing or ‘cryopreserving’ the cells in the laboratory until they are required
Administering high dose chemotherapy to deplete the patient’s immune system by destroying the remaining cells within the bone marrow (conditioning)
Returning the thawed stem cells to the patient by infusion. Within the peripheral blood they should develop into red and white blood cells and re-establish the immune system.

This diagram, showing the aHSCT process, comes from MS Australia.

Recommendations

Stem cell treatment has generated a lot of excitement because the potential therapeutic benefits. There is real hope that stem cell transplants may assist in remyelination and may help protect the nervous system from immune attacks. aHSCT is not currently available in New Zealand for the treatment of MS. MSNZ has been actively involved in advocating it’s introduction. We are aware that both MS neurologists and haematologists also support the introduction of this treatment.

MSNZ strongly recommends aHSCT is made available to PwMS who meet the following criteria:

Those with early and active relapsing MS who are not responding to currently available treatments.
Currently funded DMTs should be used in the first instance for relapsing MS.
Stem cell treatments should only be done in established centres that strictly adhere to the International Society for Stem Cell research guidelines and should be done in the context of a clinical trial where benefits can be measured and patients closely monitored for adverse outcomes.

We proudly supported this petition for MS Patients to get aHSCT here in New Zealand, instead of having to fundraise and travel abroad for treatment. The petition closed on 30th June 2022, and we await the outcome. See the petition here.

aHSCT Webinar

Watch the recording of our aHSCT in New Zealand Webinar we hosted in May 2023. You will hear from the first NZ recipient of aHSCT, learn more about the proposed criteria and protocol, the recommended post-transplant rehabilitation protocol and exciting research taking place by New Zealand researchers.