There are many treatments for multiple sclerosis besides copaxone and interferons. These two are called disease-modifying because they were the first to be statistically demonstrated on placebo-controlled studies. These studies showed that glatiramer acetate (copaxone) and interferons reduce in about 50% the recurrence of crises the disease causes. This is a very important argument as we have seen over the last two months many patients with chronically progressive multiple sclerosis being treated with interferon and glatiramer. It has not been proved that these drugs have an effect on the chronically progressive phase of the disease, being it primary or secondary. Results are only present on the relapse and remission phases. However, these were the first studies to receive huge funds, millions of American dollars invested, what did not happen with the already patented chemotherapies that have no further commercial value.

Chemotherapies can fully halt autoimmune disorders in general and multiple sclerosis in special. In a low dosage, much lower than the one used for cancer, chemotherapies are immunosuppressors with very few side effects. I, Dr Paulo R M de Bittencourt, was the precursor of this kind of treatment in Brazil and Latin America and one of the first in the world to publish results in scientific journals (Arquivos de Neuropsiquiatria, São Paulo).

Chemotherapies can be administered either by mouth in continuous daily dosage, or intravenous (IV), periodically. These treatments are called pulses or pulse therapy that can take place monthly or every few months. Cyclophosphamide is one of the pulse therapies. Till now, nothing knew, as these treatments have been known to be more efficient than interferons and they could be effective in the progressive phase of the disease. What is knew on our article published in Acta Neurologica Scandinavica is that an only dosage, big, of cyclophosphamide can, with the help of the bone marrow, lead to a long term disappearance, maybe definitive, of the disease. This only dosage is big when compared to pulse therapies used over the last 20 years, but still much smaller than the one used in cancer. It is called pre-transplant of stem cells because it mobilizes the bone marrow creating an stimuli that induces the bone marrow to produce millions of stem cells. Therefore, another possible name for the procedure is “multiple sclerosis stem cell mobilization”. The advantage it can halt the disease for a long period of time, thus, if it stops for more than 2 years, the person can slowly start to get better.

All over the world, I believe some 50 people have undergone this procedure for many diseases and 6 of my patients underwent the procedure for multiple sclerosis. One has been in definitive remission for 8 years and improved 4 points in the Kurtzke scale. This patient presents now a normal neurological exam and used to present significant paraparesis plus three crises per year. At the time the procedure was performed, the patient was 43 years old. Another patient, 30 years old, went through the procedure five months ago. She had the acute disease in continuous activity and has been asymptomatic for five months. The disease was continuous on the MRI and clinically and it has stopped for five months in both measures. A third patient has been asymptomatic since the procedure, three months ago; another, a 76-year-old patient, since the procedure in April or two months ago; a fifth patient underwent the procedure two weeks ago; and a sixth patient is undergoing the procedure this week, June 7.