Is Multiple Sclerosis Ready for the C-Word?

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Can MS be cured? Based on a recent case report, maybe.

A young man with very severe MS was treated with stem cell transplantation (HSCT), the real thing, and not the scam at your local strip mall. His level of disability did not improve but he went into a long-term remission. In MS this is termed NEDA, or no evidence of disease activity after at least 15 years. Cancer specialists are also reluctant to use the C-word and instead prefer NEDD, or no evident detectable disease.

Unanswered is the question of whether MS patients treated with immune reconstitution therapies (IRT’s), such as HCST or alemtuzumab (Lemtrada), early in their course, develop secondary progressive MS. If they do, MS must ultimately be a neurodegenerative disease. If they do not, we may indeed have a cure.

We cannot recognize early in the course whether an MS patient is cured, and the definition of cure is elusive. Is 15 years sufficient? 25 years? Must there be NEDA or would very mild disability suffice? Do these distinctions matter to an individual patient?

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