UNDERSTANDING HOW HSCT WORKS
This treatment is designed to reset your immune system and halt the progression and activity of multiple sclerosis. HSCT has been described as a ‘re-boot’ for the immune system. In many respects this simplistic explanation is the easiest way to understand how the procedure works. In the same way that you re-boot your computer when it is playing up, HSCT re- boots your immune system. The immune system restarts. It stops dis-functioning and it returns to working properly, the way that it did prior to MS. The new immune system has no cell memory of malfunction and therefore no longer attacks the nerves(Myelin.) The body has a chance to repair the damage previously inflicted! No more MS!
HSCT affects a cure for MS by either completely or partially wiping out the memory of the bodies immune system. There are two ways to do this. Myleoablative HSCT is the harsher treatment and thoroughly deletes the memory. Non Myleoblative HSCT uses a different method that only partially removes the bodies memory of the immune system. Both forms affect a change of the body’s overall T and B-lymphocyte(antigen binding) collection. This makes autoimmunity inactive and causes the body’s immune cells to become “antigen naive”. Consequently the body becomes Immune self-tolerant once again.
Ultimately this stops the underlying MS disease activity & progression. “Resetting of the immune system” has then taken place. After HSCT treatment the body can repair itself. Sometimes this means that it can reconfigure adaption to existing neural damage. Alternatively the body has an opportunity to repair itself without the continuing onslaught of disease activity. The result is an improvement of existing conditions and ongoing recovery of lost functions.
CHEMOTHERAPY IS AN ESSENTIAL PART OF HSCT
During HSC, chemotherapy destroys the ‘T’ and ‘B’ lymphocytes in the blood. These are the cells that carry the faulty memory and attack the Myelin. Once eliminated, un-programmed Virgin cells, which are manufactured in the Bone Marrow are infused into the body to replace them. Successful HSCT is entirely dependent on the chemotherapy aspect of the treatment. It explains why simply injecting stem cells into the body does not render the body’s immune system self-tolerant. It is imperative that the chemotherapy destroy the bad cells first. After this is completed, new virgin cells are harvested from the bone marrow. Finally these cells regulate the immune system the body to get the new immune system firing on all pistons!
STIMULATING PRODUCTION OF STEM CELLS
In order to stimulate the production of new stem cells, injections are given twice a day for approximately 4 days. This process is called mobilization. Mobilization is a very straightforward process, although it may cause mild bone pain. Over-the-counter pain killers should be sufficient to alleviate any discomfort caused.
COLLECTION OF STEM CELLS
“Apheresis” is the word given to the collection of new stem cells. Some people experience a little pain in the hip, but in most cases the procedure is pain free. Blood is withdrawn through a catheter and circulated through a cell-separating machine. This machine separates and collects white blood cells and this includes the stem cells. The remaining blood cells are returned to the body at the same rate that they were removed. After collection the cells are frozen and stored under special conditions. They are thawed once they are needed for transplant (reintroduction to the body).
Administration of chemotherapy takes four days. This wipes out the existing immune system. Analysis of the blood evaluates when the system is adequately prepared for the stem cell transplantation. Once confirmed that the “wipe out” of the immune system has been successful isolation begins. This means that the body is effectively devoid of its previously malfunctioning immune system. Isolation will then begin and only attending medical staff can enter the isolation area. Isolation is necessary to prevent the HSCT patient being exposed to germs. At this stage the immune system is non existent, so the patient must have the extra protection that Isolation offers.
PERFORMING THE STEM CELL TRANSPLANT
Once the Chemotherapy ends, preparation of the thawed and newly harvested stem cells begins. The next part of the procedure is to reintroduce them to the body. This is similar to a blood transfusion. People have commented on symptoms that include nausea, diarrhea, cough fever, chilling and often a headache. Medication eases these symptoms and the associated discomfort is short lived. The trade off at the end of the day is incomparable in terms of what it offers! The frozen stem cells defrost in warm water, quite simply and infused back into the body.
THE ENGRAFTMENT PART OF THE PROCEDURE
During HSCT treatment, ‘engraftment’ is the next stage of the process. ‘Engraftment’ is the word used to describe the growth of the newly harvested stem cells within the body. This usually takes within one and three weeks. It is confirmation that the new immune system is now producing blood cells as expected. Patients have reported experiencing aching in the bones, lower back, thighs and pelvis during this phase. The newly functioning immune system will be now be totally devoid of memory MS!
The immune system will now be operating normally. The blood count will rise and the white cells in the blood will resume work. They will again be fighting off bacteria and preventing infections. Shortly after this happens the hospital releases the patient. It is important to remembered that the immune system will remain compromised for some time. All facilities advise being cautions about exposure to germs or illness for at least a year after HSCT.
THE RECOVERY PHASE
The complete recovery phase takes twelve to eighteen months. If you have MS you will be aware that MS symptoms are like fingerprints. Each person will have their own specific version of the disease. In this respect recovery with HSCT is similarly unique to each patient. Some people have reported seeing continued improvement long after the procedure. They claim that improvements have taken place as long as 5 years post transplantation. Depending on the type of MS diagnosed prior to receiving treatment, results can vary considerably.
Please see “what to expect” http://www.hsctstopsms.com/what-is-hsct/. HSCT has been successful in halting disease progression in all types of MS. A small percentage of people experience ‘failure’ (approximately 15-20 percent). The HSCT facility in Russia has successfully treated several Primary Progressive patients. The most exciting part of getting HSCT is finding out that the procedure has been successful. Success means that the previous underlying disease activity has ended. The icing on the cake is experiencing improvement and often reversal of pre-existing symptoms. There have been some truly miraculous recoveries.