Plasma replacement helps some MS patients, study finds

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September 21, 1999
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(CNN) -- A treatment involving replacement of blood plasma in acute multiple sclerosis patients caused improvement approximately 40 percent of the time, according to a Mayo Clinic study released Friday.

When a patient has MS, the body attacks its own central nervous system and can cause paralysis and speech loss. Those who suffer acute cases are not helped by the standard treatment of anti-inflammatory steroids.

The Mayo study participants suffered from disabling attacks of the disease and did not respond to standard treatments. Eight out of 19 patients, or 42 percent, who underwent plasma exchange as part of the study showed dramatic improvement in their motor skills.

The procedure has been used to treat other illnesses, and in the Mayo study showed "moderate to marked improvement" in the neurological condition of MS patients when it was repeated every two days for 14 days.

"We are very excited about the success of plasma exchange, which offers another option for multiple sclerosis patients with devastating attacks who have been unresponsive to all other forms of therapy," neurologist and study leader Dr. Brian Weinshenker said.

In plasma exchange, a patient's blood is removed, and the blood cells are separated from the fluid plasma. The blood cells are then combined with new plasma and returned to the patient.

Researchers are not sure why the treatment is effective but speculate that plasma replacement helps slow the attack on the nervous system by antibodies contained in the plasma before replacement.

Doctors caution that this treatment is a last resort and is really only for a small group of acute MS sufferers who do not respond to steroids, about 1 percent, or 2,500, of the 250,000 MS sufferers in the United States.

"We really don't know how useful this procedure would be and how it would compare with other procedures being developed beyond that one population," said Dr. Stephen Reingold of the National MS Society.

Of the original eight patients who responded well to the plasma exchange, four experienced recurrent attacks during six months of follow-up.

Scientists hope this study will open new lines of research into the cause of MS.

"It provides great hope that if we can figure out exactly what it is that is happening in these patients, we remove their plasma and these patients have significant neurological improvement, the same can be applied for other MS patients," Weinshenker said.

The Mayo study was presented Friday at a conference on MS in Basel, Switzerland. It will be published in the journal Annals of Neurology in December.

Medical Correspondent Eileen O'Connor and Reuters contributed to this report.