50 msfocusmagazine.org Fatigue, leg function may help predict disease progression A new study found that in older people with MS, having fatigue and limited leg function is more often seen in people who had transitioned to the secondary progressive form of the disease than in those those who had not. Dr. Thrower: Not all MS is created equally. Seems pretty obvious, right? The varied nature of MS from person to person means that there is no one-size-fits-all treatment plan. Researchers are constantly looking for ways to accurately predict how an individual’s MS is going to behave and tailor our treatment accordingly. The timing of these findings may be particularly important with the recent approval of Ocrevus. Ocrevus could be an option for individuals like those described in this study. It’s also important to remember that some fatigue and walking issues may be because of deconditioning and might get betterwith physical therapy or an appropriate wellness program. Study: Stem cell treatment can slow, stop MS for up to five years A new study suggests stem cell therapy can slow or stop progression of MS for years, and the treatment is most effective in people with MS who have active inflammation in their brain and spinal cord. Researchers said the study is one of the largest to date looking at stem cell transplantation as a treatment for MS, and the findings offer some encouraging insights. Dr. Thrower: Any discussion of stem cells in MS usually generates significant interest. The stem cell procedure is called hematopoietic stem cell transplantation (HSCT) orautologous stem cell transplantation, and is a type of bone marrow transplant. The idea is to give the person with MS a “new” immune system, one that will not attack myelin and damage nerve fibers. The cells used for the procedure are from the person themselves rather than from a donor. While the exact methods may vary, the basic steps are: 1) Conditioning. Medications are given to encourage the bone marrow to produce more stem cells. 2) Harvesting. The stem cells are collected from the blood of the person with MS. These cells are saved and frozen. 3) Immune Ablation. The person with MS gets chemotherapeutic drugs to wipe out the existing immune system. Medicine & Research Doctor’s Notes The Doctor’s Notes column includes analysis from Ben Thrower, M.D., MS Focus Senior Medical Advisor. Dr. Thrower draws from the top news stories of the quarter and explains what the news means to you, the person with MS.