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Actress Selma Blair is using an experimental stem cell therapy called HSCT to treat her multiple sclerosis. Image: Instagram
  • Selma Blair revealed via Instagram that she is undergoing a stem cell treatment called hematopoietic stem cell transplantation (HSCT) to slow down her multiple sclerosis.
  • This experimental treatment uses chemotherapy to reset and rebuild a patient’s immune system.
  • The therapy includes many of the risks and side effects of traditional chemotherapy, including hair loss.
  • In recent phase 2 clinical trials, HSCT showed promise in slowing the progression of relapsing-remitting MS compared to existing disease-modifying drugs.

In a recent Instagram post, actress Selma Blair showed off her newly shaven head and announced she “did HSCT” in an effort to slow down the progression of her multiple sclerosis.

This left many in the MS community wondering about the specifics of this new and relatively unknown treatment for MS.

Hematopoietic stem cell transplantation (HSCT) is a complicated and still experimental therapy that uses mild to stronger forms of chemotherapy to reset a patient’s immune system, erasing the memory of MS.

MS is largely recognized as an autoimmune condition, where the body’s natural defenses become confused and attack healthy tissues in the central nervous system.

HSCT carries many of the side effects associated with traditional chemotherapy, including hair loss, which likely explains Blair’s social media posts.

In 2018, the first phase 2 clinical trial for HSCT was performed by Dr. Richard Burt, chief of immunotherapy and autoimmune diseases at the Northwestern Feinberg School of Medicine in Illinois. Some called it a game changer.

A common misconception is that HSCT will reverse MS progress. It has only shown success in stopping MS activity.

“Bone marrow does not provide new cells for brain building. They give you derived bone marrow cells like T and B cells,” Dr. Jaime Imitola, FAAN, director of multiple sclerosis and translational neuroimmunology at the University of Connecticut School of Medicine, told Healthline in an earlier conversation.

In January, JAMA published the results of a study, led by Dr. Burt, showing HSCT more effective than current disease-modifying treatments. Only 3 of the 51 patients on HSCT showed disease progression compared to 34 of the 52 on DMTs. (110 patients were recruited for the study, but only 103 remained for the final in analysis.)

Burt was not available for comment.

“HSCT is showing best results for those with pretty aggressive relapsing MS and are not responding to another therapy,” Bruce Bebo, PhD, executive vice president of research at the National Multiple Sclerosis Society, told Healthline, “It doesn’t show that it works well with progressive forms of MS.”

He further explained that HSCT does not fall under the jurisdiction of needing an FDA approval because it is a procedure and not a specific drug. All the medications and protocols used are FDA approved for other indications.

“HSCT is not readily available. We still need more well-done clinical trials demonstrating the full risks and benefits of this procedure,” Bebo encouraged. “The medical community is starting to embrace HSCT.”

The American Society for Transplantation and Cellular Therapy recently published new guidelines to help guide general practitioners to hematopoietic stem cell transplantation.

In order for HSCT to be more available, the medical community has to be convinced that it is a safe and effective treatment for MS. “They must make an investment in training people to do these therapies,” Bebo said.

“HSCT saved my life,” David Bexfield, founder of activemsers.org, told Healthline.

Since his treatment, Bexfield has traveled to almost 30 countries.

“I shaved my head,” said Bexfield, “And, had fun with it!”

In 2010 David Bexfield had an HSCT transplant performed at MD Anderson Cancer Center as part of HALT-MS, an NIH-sponsored clinical trial.

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David Blexfield, founder of activemsers.org, used HSCT to slow down his quickly advancing MS back in 2010. Image courtesy of David Blexfield

“My MS had turned scarily aggressive,” said Bexfield, explaining how his score on the Expanded Disability Status Score (EDSS) dropped two points in two months. “In the spring of 2009, I picked up a cane for the first time. By fall I couldn’t cross living floor without a walker.”

A friend had forwarded the clinical trial to Bexfield in spring of 2009. His first thoughts, “I’d have to be crazy or desperate to do it.”

“Six months later I was desperate,” he said.

David and his wife, Laura, had to move from Albuquerque, New Mexico, to Houston, Texas, for three months. During that time he was in the hospital for three weeks to have the procedure.

“It was hard but not impossible,” said Bexfield.

“I had lots of hope that it would at least arrest the progression of the disease.” His wife, Laura, had the same feeling that it was worth the gamble because of the aggressiveness of the MS.

“Treatment is hard. There were days when I could not get out of bed no matter what.”

Bexfield noticed benefits in the first couple of months.

In order to qualify for the study Bexfield had to walk 100 meters, unaided, which was a struggle. “My mobility skyrocketed after the treatment and I walked 700 meters.”

“The treatment held for about four years before effects of transplant started to fade, then I went on to a DMT,” Bexfield told Healthline.

The thought crossed his mind to have another treatment but he decided it was not feasible.

“HSCT is not a cure for MS. It’s a treatment option,” emphasized Bexfield.

“I have absolutely no regrets,” he told Healthline. Bexfield uses mobility devices to get around and he exercises every day.

Bebo explained that some procedures for MS use more mild forms of chemotherapy to keep part of the immune system in tact. Other procedures using stronger chemo carry greater risks.

“If you don’t have any evidence of immune activity driving your disease, then clinics in U.S. and Canada will not give the treatment,” Bebo said, “But Mexico and other countries may offer this service. We do not know their outcomes as there is no data published about success or risks.”

The potential success in HSCT has created high demand for the treatment, resulting in dangerous “stem cell tourism,” where people with MS travel to other countries for unauthorized treatments.

“Once you do [HSCT] you can’t go back. It is making a permanent change to your immune system,” he said. “We do not know what the long-term consequences will be.”

Editor’s note: Neither Blair nor her representative were available to comment on this story.

Caroline Craven is a patient expert living with MS. Her award-winning blog is GirlwithMS.com, and she can be found on Twitter.