Intrathecal Mesenchymal Stem Cell Therapy in Multiple Sclerosis: A Follow-Up Study for Five Years After Injection

Abstract

Background: Mesenchymal stem cell therapy has been used in multiple sclerosis (MS) in order to modulate the course of the disease in previous studies. One of the major concerns in such cases is long term safety or efficacy of this type of therapy. Objectives: This study was conducted to report the clinical status of five patients with secondary progressive multiple sclerosis and one patient with neuromyelitis optica, five years after an autologous intrathecal mesenchymal stem cell (MSC) injection. Patients and Methods: The patients (three male, three female) had a progressive course nonresponsive to the conventional immunomodulatory treatments with Expanded Disability Status Scale (EDSS) score of 3.5 to 6. They received the MCSs after discontinuing other treatments. They were examined annually to assess the disease activity and possible complications. Results: Two patients had no change in their EDSS scores. One was diagnosed to have Devic’s disease decreased one score in the EDSS, but experienced four relapses during these five years. Three patients had an increase in EDSS scores by 1-2 scores after five years. Two experienced relapses after injection. There was no significant adverse reaction, infection, or neoplasm during this period of follow up. Conclusions: Intrathecal mesenchymal stem cell therapy for MS is generally safe and did not result in any adverse reaction like malignancy for a relatively long period of time. At least half of the patients had no change in their EDSS and the remaining patients had a delay in disease progress.