Tonight on Panorama: Exclusive access to patients pioneering a radical treatment for an incurable disease. Multiple Sclerosis affects 100,000 people in the UK, most of them diagnosed in their 20a and 30s. Now there is hope that a bone marrow stem cell transplant, usually given to cancer patients, could stop MS in its tracks, preventing lifelong disability. This s-called immune system reboot could be revolutionary.
Panorama – Can You Stop My Multiple Sclerosis
Steven Storey was diagnosed with MS two years ago. In that time, he’s gone from being a marathon runner to losing the use of his legs.
Steven Storey “Before MS life was fantastic. I used to do lots of sports, triathlon, mountain marathons, cycling. I did a lot of climbing. I spent a lot of time with the kids and doing lots of those things with them as well.”
Now he’s back kayaking with his daughters for the first time since his diagnosis. Steven hopes he will one day walk again. He’s part of a group of MS patients in Sheffield undergoing a cancer treatment at the – at the Royal Hallamshire Hospital.
Paul Kirkham is one of 100 people a week in the UK diagnosed with MS. He’s being assessed by neurologist Professor Basil Sharrack in the hospital of starting the intensive stem cell treatment.
Immune System Reboot with Stem Cell Transplant
MS occurs when the immune system mistakenly attacks the protective insulation around nerve fibres in the brain and spinal cord causing inflammation, just as a frayed electrical wire short-circuit the nerve fibres malfunction. This can cause a huge range of symptoms from fatigue and pain to balance and walking problems and sometimes permanent disability.
For 13 years Paul’s MS was mild, but the disease recently became aggressive forcing him to stop work. Despite Paul’s MS the family used to enjoy all kinds of sports together but now, skiing is no longer possible.
Professor John Snowden, a specialist in treating blood cancers, hopes to fix Paul’s immune system with a standard treatment in his field, a bone marrow transplant.
Professor John Snowden “We would hope to rebuild your immune system in a slightly different way. It will still be your immune system. It’s not actually a true transplant, because it’s going to be stem cells from yourself. In effect an immune system that has been reset or rebooted back to a time point before it caused MS.”
Professor John Snowden
This reboot of the immune system uses the patient’s own stem cells found in their bone marrow. These cells are at such an early stage, they’ve not developed the flaws that trigger Multiple Sclerosis. But the transplant is an arduous treatment.
Professor John Snowden “We have to mention that occasionally some people have quite a difficult time with this type of treatment, because it does involve intensive chemotherapy and transplant procedure.”
Paul’s first dose of chemotherapy, which is combined with growth hormones is designed to flush out stem cells from his bone marrow. A week later, the drugs have done their work. The stem cells have left the bone marrow and are now circulating in his blood, ready to be harvested.
Paul Kirkham “They’re going to start sieving the stem cells out of me body. It’s amazing what they can do.”
Blood is taken out of one arm and the stem cells skimmed off and collected, whilst in Paul’s other arm, the rest of the blood is returned.
Louise Barritt lives with her fiance, Steve and her son Owen. Like more than eight in 10 MS patients, Louise has the relapsing remitting form of the disease, which this therapy hopes to treat. It means she suffers acute attacks, relapses, but with periods of recovery in-between.
MS takes its toll not just on her body, but her mind.
Louise Barritt “The biggest thing is the fatigue and just feeling absolutely exhausted and not just feeling tired, but it’s the brain fog and the inability to concentrate and follow conversations and make decisions.”
Louise has already started her stem cell treatment at the Royal Hallamshire. Her stem cells have been harvested, so Louise is about to go back into hospital where she’ll be kept in isolation to prevent infection while doctors first delete and then reboot her immune system. Owen won’t be able to visit his mother for several weeks during this second phase of the treatment.
Louise doesn’t have cancer but is about to start aggressive chemotherapy and knows it will have side-effects. Louise is now in isolation, she’s had her chemotherapy and has reached a critical day in her treatment.
Louise Barritt “This is what they call day zero, it’s transplant day.”
Inside this tank, stored in liquid nitrogen, are the stem cells that could transform her health. Hopefully, rebuilding her immune system free of Multiple Sclerosis.
Nurse “Louise is due her stem cells today, on the 13th. She’s had all her chemotherapy over the weekend. We’re good to go.”
Just two bags containing two cupfuls of Louise’s own stem cells are all it takes to rekindle her immune system. For nurses treating cancer this is routine practice.
Nurse “What happens to these cells is they hover around in your circulating blood system for three of four days and then they have, like a homing mechanism on them, and they migrate into the marrow.”
More than a hundred patients with relapsing remitting MS are being recruited in four cities, Sheffield, Chicago, Stockholm and Sao Paulo to a major trial which will report in a couple of years and could establish this as a mainstream treatment.
For Paul, it’s also day zero.and like Louise his stem cells are also being transplanted. Once they’re established, both can go home.
Steven is back on this ward for the first time since his transplant to visit Paul. Steven used to compete in triathlons but then out of the blue, MS struck him down.
Steven Storey “I was crossing the road. I did not fall, I just melted. My bodywas unable to get across the road and I slumped onto the floor. Somebody came over to help me and the next day I came into the hospital.”
Within nine months, Steven’s condition had deteriorated to the point where he needed 24-hour acute care.
Steven Storey talking to Paul Kirkham “At your stage now I was completely paralysed, unable to even flicker my toe, unable to do anything. There’s a point in your spinal cord called T10. From there down I had zero sensation and zero muscle flicker. I had a feeling it would be the rest of my life like that, I had a conversation with my kids about mortality. The prognosis could well have been continuing the speed of decline, respiratory failure, intensive care, we know where that ends.”
Almost immediately the treatment allowed his nervous system to start to recover. Just ten months later, Steven completed a mile-long swim in the lake district. But for Steven the treatment came only after Multiple Sclerosis had already done severe damage to his nervous system, so there may be limits to his recovery.
But if relapsing remitting Multiple Sclerosis is caught in time, could it be stopped in its tracks?
Holly Drewry was just 21 when she was diagnosed. After giving birth to her daughter, Holly’s condition deteriorated quickly.
Holly Drewry “I couldn’t walk steadily. I did not trust myself holding her in case I had a fall. I was a new mum and I wanted to do it all properly. The MS was stopping me from being able to do it. This all happened within a couple of months and then I had to get a wheelchair. I got worse and worse. I could not wash myself, I couldn’t dress myself. It was scary because I thought, where is it going to end?”
Standard drug and blood treatments had failed for Holly. The transplant involves a one-off cost of £30,000 no more expensive than the yearly cost of some MS treatments which need to be taken for life.
Holly had the experimental transplant and for her, the improvements were astonishing.
Holly Drewry “I saw improvements in days. I walked out of hospital.”
It’s now two years since Holly’s stem cell transplant and she’s come back to review her progress. Left untreated, areas of active inflammation would cause permanent damage. But now, they’ve all but disappeared. Holly’s Multiple Sclerosis has been dramatically halted. She will need to be monitored for years but the hope is the transplant will be a permanent fix.
Professor Basil Sharrack
Professor Basil Sharrack “When I was doing my training we had treatment for multiple sclerosis. To have a treatment which can potentially halt the disease is a good treatment.”
After eighteen days Louise finally leaves the isolation unit. Paul is back home, twelve days after his transplant.
Professor John Snowden “This is indeed a very potent treatment and time will tell whether it is a cure or not. We need to have longer-term follow-up which perhaps goes into decades before we can say cure.”
Stem cell transplantation for MS is experimental and its long-term benefits are unproven. But, if the international trial, which Sheffield is part of, is a success then many more MS patients might be offered it in years to come.