What is Multiple Sclerosis?

1MS explained
Multiple sclerosis is a chronic, unpredictable disease of the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves. It is thought to be an immune-mediated disorder, in which the immune system incorrectly attacks healthy tissue in the CNS. MS can cause many symptoms, including blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, and blindness and more. These problems may come and go or persist and worsen over time. Most people are diagnosed between the ages of 20 and 50, although individuals as young as 2 and as old as 75 have developed it.
2Who gets MS?
Anyone may develop MS but there are some patterns. More than two to three times as many women as men develop MS and this gender difference has been increasing over the past 50 years. Studies suggest that genetic risk factors increase the risk of developing MS, but there is no evidence that MS is directly inherited. Environmental factors, such as low Vitamin D and cigarette smoking have also been shown to increase the risk of MS. MS occurs in most ethnic groups, including African-Americans, Asians and Hispanics/Latinos, but is most common in Caucasians of northern European ancestry.
3What causes the symptoms?
MS symptoms occur when the immune-system produces inflammation within the CNS. The inflammatory attack damages myelin, (the protective insulation surrounding nerve fibers), oligodendrocytes (cells that make CNS myelin) and sometimes the underlying nerve fiber. The damage caused by inflammation can produce symptoms that resolve over weeks to months or symptoms that are permanent.
4Can MS be cured?
Not yet. There are now FDA-approved medications that have been shown to "modify" the course of MS by reducing the number of relapses and delaying progression of disability to some degree. In addition, many therapeutic and technological advances are helping people manage symptoms. Advances in treating and understanding MS are made every year, and progress in research to find a cure is very encouraging.
5Does MS always cause paralysis?
No. Moreover, the majority of people with MS do not become severely disabled. Two-thirds of people who have MS remain able to walk, though many will need an aid, such as a cane or crutches, and some will use a scooter or wheelchair because of fatigue, weakness, balance problems, or to assist with conserving energy.
6Is MS fatal?
Life expectancy for people with MS has increased over time. We believe this is due to treatment breakthroughs, improved healthcare and life style changes. Recent research however, indicates that people with MS may live an average of about seven years less than the general population because of disease complications or other medical conditions. Many of these complications are preventable or manageable. Attention to overall health and wellness can help reduce the risk of other medical conditions, such as heart disease and stroke, that can contribute to a shortened life expectancy. In some rare instances, there are cases of MS that progress rapidly from disease onset and can be fatal.



What is Autologous Haematopoietic Stem Cell Transplant (AHSCT)?

Haematopoietic stem cells are a type of adult stem cell found in the blood and bone marrow. Haematopoietic stem cells are able to generate new blood and immune cells. Autologous haematopoietic stem cell transplant (AHSCT, also known as bone marrow transplant) used for MS is similar to the chemotherapy treatment used to treat blood cancers – chemotherapy is used to eliminate the immune system, and then the blood and immune system are restored, in this case, using the patient’s own (autologous) blood stem cells. The aim is to ‘re-boot’ the immune system so that the self-reactive immune cells that are attacking an individual’s nervous system are removed, and replaced with the regenerated immune system, which is thought to be more ‘self-tolerant’ and less likely to continue attacking the body. The stem cells are not thought to contribute to repair of the nervous system, but are primarily used to restore the blood and immune system following the immuno-suppressive chemotherapy treatment.

AHSCT is an intensive form of treatment which involves a number of steps, including:
      Pre-treatment to release bone marrow stem cells into the blood.
      Collecting or ‘harvesting’ the AHSCs from the blood of the patient.
      Freezing (cryopreserving) the AHSCs in the laboratory until they are required.
      Administering immuno-chemotherapy to remove the patient’s current immune system (conditioning).
      Returning the thawed AHSCs to the patient by infusion into the veins.
Supportive medical treatment is provided in the immediate period following transplant when there is a high risk of infection and bleeding disorders due to the intense immune suppression.