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Share on Pinterest SDI Productions/Getty ImagesA stem cell treatment commonly used for blood cancer appears effective in treating one form of MSThe treatment has been available since the 1990s but questions about safety and difficulty have limited its impactNew research suggests it is safer and would benefit more people with MS than previously believed.

A stem cell therapy for multiple sclerosis (MS) appears to be generally safe and effective, but it isnt widely utilized. Researchers in Sweden are trying to get the word out.

Multiple sclerosis (MS) is a devastating illness that has proven difficult to treat and impossible to cure. But for some MS patients there may be an option available that has been waiting in the wings for decades.

Autologous hematopoietic stem cell transplantation (aHSCT) is primarily used to treat cancers of the blood, but has been used in the treatment of MS since the 1990s.

However, questions about its safety and the difficult nature of the procedure have prevented it from becoming a standard part of MS care.

In an article published this week in the Journal of Neurology Neurosurgery & Psychiatry, researchers in Sweden found that aHSCT is a suitable treatment for a form of MS known as relapsing-remitting multiple sclerosis.

Because aHSCT has been studied predominantly in clinical settings, they wanted to see how the procedure worked in actual patients in traditional healthcare settings. They conclude that the treatment is not only safer and more effective than previously believed but that the procedure could potentially impact even more people living with MS.

Our findings suggest that aHSCT could benefit a greater number of MS patients and it should be included as a standard of care for highly active MS. AHSCT has been viewed as a high-risk procedure in the past, but our findings challenge this view and we conclude that the procedure can be performed safely in experienced hands, Dr. Joachim Burman, a member of the Department of Medical Sciences at Uppsala University in Sweden, and co-author of the research, told Healthline. Effects on real MS patients

To investigate, Burman and his team pulled data from the Swedish MS registry and the European Society for Blood and Marrow Transplantation registry to find patients with relapsing-remitting multiple sclerosis who had been treated with aHSCT.

They initially identified 231 patients and the final analysis included 174 that met all of their criteria. This criteria included that they had to have relapsing-remitting multiple sclerosis and not another form of MS and had to have received their aHSCT treatment prior to 2020. Patients had a median follow-up time of 5.5 years.

The primary outcomes that the researchers were looking at were safety, as indicated by the occurrence of adverse events like infection or death; and disease progression.

The study showed no evidence of disease progression in 73% of patients after 5 years and 65% after 10 years. Of the 149 patients that had some form of disability at the beginning of the observation period, 54% showed improvement, 37% were stable, and only 9% showed worsening symptoms.

This really is confirmatory because this study is quite consistent with many previous studies that have shown that aHSCT therapy can be beneficial for some people living with MS, Bruce Bebo, Executive Vice President of Research at the National MS Society, told Healthline. Costs and benefits

Patients did experience adverse events during the observation period.

The most common was febrile neutropenia (low white blood cell count accompanied by fever) which occurred in almost 70% of patients, and low potassium or hypokalemia. Five patients required intensive care within 100 days of treatment.

One death was reported but no treatment-related deaths were reported.

Adverse events were found to be manageable within traditional healthcare environments.

This procedure has been perceived as a high-risk procedure, but as we have shown it can be performed quite safely, said Burman.

Despite his findings though, aHSCT is still a serious procedure.

In MS, the immune system attacks part of the brain, spinal cord, and nerves; specifically, it damages the myelin sheath, a fatty substance that acts as insulation around nerves, and ultimately causes disability.

The goal of aHSCT is to reset the immune system and prevent it from further damaging the nervous system. The entire process requires blood stem cells to be collected from the patient and then frozen. The patient then undergoes chemotherapy to suppress the immune system. In this immunosuppressed state, the previously collected blood cells are then altered and reintroduced to the body.

The process involves weeks in the hospital, chemotherapy, and immunosuppressive medication that lower the bodys natural ability to fight off infection.

Chemotherapy is used to ablate the bone marrow, and then the marrow is reconstituted with stem cells. This involves a 3-4 week stay in hospital, and patients are vulnerable to infection while the marrow is repopulating. Historically there is about a 2% mortality rate with AHSCT, but there is more experience with the chemo regimens now and no deaths were seen in the trial, said Dr. Christopher Lock, Clinical Associate Professor of Neurology & Neurological Sciences, and Clinical Trials Director for Multiple Sclerosis at Stanford University.

Its not a trivial treatment, said Bebo, While the protocols and techniques and drugs and things used over the last 10 or 20 years have been refined and the safety has been improved dramatically, it still comes with significant risks and side effects and needs to be considered carefully by anybody who is thinking about this. Who should consider aHSCT

The National MS Society Guidelines recommend aHSCT for individuals who:Have relapsing-remitting multiple sclerosisAre less than 50 years oldHave had MS for less than 10 yearsAre not responding to typical disease-modifying therapy

For some, the risk will likely be worth it. Nearly one million people live with MS in the United States and the disease affects three times as many women as men. It is the leading cause of permanent neurological disability in young adults. MS is also notoriously hard to diagnose. There are multiple forms of it as well. Relapsing-remitting multiple sclerosis is the predominant form of MS, and is characterized by bouts or flare ups that can cause vision problems, muscle weakness, numbness or tingling, fatigue, and more. These attacks clear up over time and are generally followed by a remission period. Flare-ups inevitably follow, and with each one the potential for worsening of symptoms.

Relapsing-remitting multiple sclerosis is sometimes followed by another form of MS called secondary progressive MS (SPMS). This type of MS is characterized by its progressive nature, meaning that neurologic function worsens and disability increases over time.

AHSCT treatment is only for individuals with relapsing-remitting multiple sclerosis and not other forms.

We would generally reserve [aHSCT] for patients with aggressive forms of relapsing MS, and who are refractory to or have failed first- and second-line therapies. There are currently over 20 disease modifying drugs approved for MS, and we would try these first, said Lock.

Disease modifying therapies (DMTs) are generally the first line of treatment for people with MS. DMTs help to prevent permanent damage to the central nervous system, control flare-ups, and improve every day symptoms.

But Burman believes that his work should help to inform more doctors about the procedure and help to open the door to more individuals with MS looking for an effective treatment.

About 5-10% of MS patients have an aggressive disease with rapidly evolving disability. These patients should all be candidates for aHSCT. Some patients (maybe 20%) have very mild disease and should opt for regular treatment. There is a large middle group, which previously has not been considered for aHSCT, but I think that aHSCT could at least be considered in these cases, he said. The bottom line

Autlogous hematopoietic stem cell transplantation (aHSCT) is effective and generally safe for treating relapsing-remitting multiple sclerosis.

New research contends that the procedure is safe and effective enough that it be included as part of the standard of care for relapsing-remitting multiple sclerosis.

AHSCT is still a serious procedure that requires hospitalization and immunosuppressant drugs. It is only recommended for certain individuals with relapsing-remitting multiple sclerosis.

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Vladimir Putin demands key regions of Ukraine in ‘exchange for peace’

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Vladimir Putin demands key regions of Ukraine in 'exchange for peace'

Vladimir Putin made demands to take control of key regions of Ukraine during his talks with Donald Trump, it has been widely reported, as a condition for ending the war.

During their summit in Alaska, the Russian leader is said to have told the US president he wants the eastern Donetsk and Luhansk regions – and would give up other Ukrainian territories held by his troops in exchange.

The plans were reported by several news outlets, citing sources close to the matter, as Mr Trump scheduled a further meeting with Ukrainian president Volodymyr Zelenskyy in Washington DC for Monday. He has said this could potentially pave the way for a three-way meeting with Mr Putin.

Mr Trump reportedly backs the plans, according to some outlets – but Mr Zelenskyy has previously ruled out formally handing any territory to Moscow. Russia already controls a fifth of Ukraine, including about three-quarters of Donetsk province, which it first entered in 2014.

US-Russia talks on Ukraine – latest updates

Pic: AP/ Julia Demaree Nikhinson
Image:
Pic: AP/ Julia Demaree Nikhinson

Details of the plans emerged after little was revealed during the high-profile summit between the US and Russian leaders on Friday.

Despite threats by the US president beforehand, of sanctions for Russia should there be no agreement on a ceasefire, a short news briefing after the talks ended with no mention of a suspension of fighting, no announced agreement on how to end the war, and little clarity about the next steps.

On Saturday, Mr Trump appeared to change his stance on what he hopes to achieve in Ukraine, indicating he wants a permanent peace settlement rather than a ceasefire.

“It was determined by all that the best way to end the horrific war between Russia and Ukraine is to go directly to a Peace Agreement, which would end the war, and not a mere Ceasefire Agreement, which often times do not hold up,” he said in a post on his social network site, Truth Social.

Pic: Sergei Bobylev/ Sputnik/ Kremlin pool via AP
Image:
Pic: Sergei Bobylev/ Sputnik/ Kremlin pool via AP

Trump: ‘Russia is a big power – they’re not’

In an interview with Fox News following the summit, Mr Trump signalled he and Putin had discussed land transfers and security guarantees for Ukraine, and had “largely agreed”. He said Ukraine has to made a deal, as “Russia is a very big power, and they’re not”.

Monday’s meeting at the White House will be the Ukrainian president’s second this year. His last descended into a fiery spat with Mr Trump and his vice president JD Vance, which saw him leave early.

After the fresh meeting was announced, Mr Zelenskyy in a post on X that he was grateful for the invitation.

Read more:
Key takeaways from Sky correspondents
Body language expert unpacks the summit

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Trump and Putin’s body language analysed

“It is important that everyone agrees there needs to be a conversation at the level of leaders to clarify all the details and determine which steps are necessary and will work,” he said.

However, he said Russia had rebuffed “numerous calls for a ceasefire and has not yet determined when it will stop the killing”, which “complicates the situation”.

Mr Zelenskyy continued: “If they lack the will to carry out a simple order to stop the strikes, it may take a lot of effort to get Russia to have the will to implement far greater – peaceful coexistence with its neighbours for decades.

“But together we are working for peace and security. Stopping the killing is a key element of stopping the war.”

Please use Chrome browser for a more accessible video player

Trump and Putin in Alaska – The Debrief

Putin releases statement on summit

In a statement on the summit, Mr Putin described the talks as “timely and quite useful” – but said the “removal” of what he calls the “root causes” of the crisis “must underlie the settlement”.

He continued: “We definitely respect the US administration’s position which wants the hostilities to stop as soon as possible. So do we, and we would like to move forward with settling all issues by peaceful means.

“The conversation was very frank and substantive, which, in my view, moves us closer towards making necessary decisions.”

Keir Starmer welcomed Volodymyr Zelenskyy to Downing Street earlier this week. Pic: AP/ Kirsty Wigglesworth
Image:
Keir Starmer welcomed Volodymyr Zelenskyy to Downing Street earlier this week. Pic: AP/ Kirsty Wigglesworth

European leaders who make up the “coalition of the willing” are set to hold a conference call today ahead of the crunch talks between Mr Trump and Mr Zelenskyy.

Prime Minister Keir Starmer, French President Emmanuel Macron and German Chancellor Friedrich Merz will host the video conference.

Read more:
Analysis: Putin was pulling the strings
Mapping the land Ukraine could be told to give up

In a statement on Saturday,Sir Keir said Mr Trump’s efforts had “brought us closer than ever before to ending Russia’s illegal war in Ukraine” and that his leadership “in pursuit of an end to the killing should be commended”.

He said he supported the next phase of talks, but added: “In the meantime, until (Putin) stops his barbaric assault, we will keep tightening the screws on his war machine with even more sanctions.”

Meanwhile, Ukraine’s military has reported an advance of up to 2km on the Sumy front in the country’s northeast.

“Zones of continuous enemy fire damage are being maintained,” the Ukrainian General Staff said on Telegram. “Ukrainian troops are repelling Russian forces”.

In the early hours of Sunday, a regional governor in Russia said a railway employee had been injured and a power line damaged by a Ukrainian drone attack.

The incident happened in the Voronezh region, Alexander Gusev said on Telegram.

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US

Vladimir Putin demands key regions of Ukraine in ‘exchange for peace’

Published

on

By

Vladimir Putin demands key regions of Ukraine in 'exchange for peace'

Vladimir Putin made demands to take control of key regions of Ukraine during his talks with Donald Trump, it has been widely reported, as a condition for ending the war.

During their summit in Alaska, the Russian leader is said to have told the US president he wants the eastern Donetsk and Luhansk regions – and would give up other Ukrainian territories held by his troops in exchange.

The plans were reported by several news outlets, citing sources close to the matter, as Mr Trump scheduled a further meeting with Ukrainian president Volodymyr Zelenskyy in Washington DC for Monday. He has said this could potentially pave the way for a three-way meeting with Mr Putin.

Mr Trump reportedly backs the plans, according to some outlets – but Mr Zelenskyy has previously ruled out formally handing any territory to Moscow. Russia already controls a fifth of Ukraine, including about three-quarters of Donetsk province, which it first entered in 2014.

US-Russia talks on Ukraine – latest updates

Pic: AP/ Julia Demaree Nikhinson
Image:
Pic: AP/ Julia Demaree Nikhinson

Details of the plans emerged after little was revealed during the high-profile summit between the US and Russian leaders on Friday.

Despite threats by the US president beforehand, of sanctions for Russia should there be no agreement on a ceasefire, a short news briefing after the talks ended with no mention of a suspension of fighting, no announced agreement on how to end the war, and little clarity about the next steps.

On Saturday, Mr Trump appeared to change his stance on what he hopes to achieve in Ukraine, indicating he wants a permanent peace settlement rather than a ceasefire.

“It was determined by all that the best way to end the horrific war between Russia and Ukraine is to go directly to a Peace Agreement, which would end the war, and not a mere Ceasefire Agreement, which often times do not hold up,” he said in a post on his social network site, Truth Social.

Pic: Sergei Bobylev/ Sputnik/ Kremlin pool via AP
Image:
Pic: Sergei Bobylev/ Sputnik/ Kremlin pool via AP

Trump: ‘Russia is a big power – they’re not’

In an interview with Fox News following the summit, Mr Trump signalled he and Putin had discussed land transfers and security guarantees for Ukraine, and had “largely agreed”. He said Ukraine has to made a deal, as “Russia is a very big power, and they’re not”.

Monday’s meeting at the White House will be the Ukrainian president’s second this year. His last descended into a fiery spat with Mr Trump and his vice president JD Vance, which saw him leave early.

After the fresh meeting was announced, Mr Zelenskyy in a post on X that he was grateful for the invitation.

Read more:
Key takeaways from Sky correspondents
Body language expert unpacks the summit

Please use Chrome browser for a more accessible video player

Trump and Putin’s body language analysed

“It is important that everyone agrees there needs to be a conversation at the level of leaders to clarify all the details and determine which steps are necessary and will work,” he said.

However, he said Russia had rebuffed “numerous calls for a ceasefire and has not yet determined when it will stop the killing”, which “complicates the situation”.

Mr Zelenskyy continued: “If they lack the will to carry out a simple order to stop the strikes, it may take a lot of effort to get Russia to have the will to implement far greater – peaceful coexistence with its neighbours for decades.

“But together we are working for peace and security. Stopping the killing is a key element of stopping the war.”

Please use Chrome browser for a more accessible video player

Trump and Putin in Alaska – The Debrief

Putin releases statement on summit

In a statement on the summit, Mr Putin described the talks as “timely and quite useful” – but said the “removal” of what he calls the “root causes” of the crisis “must underlie the settlement”.

He continued: “We definitely respect the US administration’s position which wants the hostilities to stop as soon as possible. So do we, and we would like to move forward with settling all issues by peaceful means.

“The conversation was very frank and substantive, which, in my view, moves us closer towards making necessary decisions.”

Keir Starmer welcomed Volodymyr Zelenskyy to Downing Street earlier this week. Pic: AP/ Kirsty Wigglesworth
Image:
Keir Starmer welcomed Volodymyr Zelenskyy to Downing Street earlier this week. Pic: AP/ Kirsty Wigglesworth

European leaders who make up the “coalition of the willing” are set to hold a conference call today ahead of the crunch talks between Mr Trump and Mr Zelenskyy.

Prime Minister Keir Starmer, French President Emmanuel Macron and German Chancellor Friedrich Merz will host the video conference.

Read more:
Analysis: Putin was pulling the strings
Mapping the land Ukraine could be told to give up

In a statement on Saturday,Sir Keir said Mr Trump’s efforts had “brought us closer than ever before to ending Russia’s illegal war in Ukraine” and that his leadership “in pursuit of an end to the killing should be commended”.

He said he supported the next phase of talks, but added: “In the meantime, until (Putin) stops his barbaric assault, we will keep tightening the screws on his war machine with even more sanctions.”

Meanwhile, Ukraine’s military has reported an advance of up to 2km on the Sumy front in the country’s northeast.

“Zones of continuous enemy fire damage are being maintained,” the Ukrainian General Staff said on Telegram. “Ukrainian troops are repelling Russian forces”.

In the early hours of Sunday, a regional governor in Russia said a railway employee had been injured and a power line damaged by a Ukrainian drone attack.

The incident happened in the Voronezh region, Alexander Gusev said on Telegram.

Continue Reading

US

Trump-Putin summit: No deal reached to end war in Ukraine

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Trump-Putin summit: No deal reached to end war in Ukraine

No deal has been reached to end the war in Ukraine – but Donald Trump has said there are “many points” he and Vladimir Putin agreed on during their highly anticipated summit.

Following the meeting in Alaska, which lasted more than two-and-a-half hours, the two leaders gave a short media conference giving little detail about what had been discussed, and without taking questions.

Mr Trump described the meeting as “very productive” and said there were “many points that we agreed on… I would say a couple of big ones”.

Trump-Putin summit – latest updates

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Key moments from Trump-Putin news conference

But there are a few left, he added. “Some are not that significant. One is probably the most significant, but we have a very good chance of getting there…

“We haven’t quite got there, we’ve made some headway. There’s no deal until there’s a deal.”

He has since suggested that negotiations should proceed directly to a peace deal, rather than purely a ceasefire agreement.

Mr Putin described the negotiations as “thorough and constructive” and said Russia was “seriously interested in putting an end” to the war in Ukraine. He also warned Europe not to “torpedo nascent progress”.

Following the summit, President Volodymyr Zelenskyy said he plans to travel to Washington DC on Monday following a “long and substantive” conversation” with Mr Trump.

In a joint statement, European leaders including Sir Keir Starmer said they “welcomed President Trump’s efforts to stop the killing in Ukraine” and said the so-called ‘coalition of the willing’ is “ready to play an active role”.

Donald Trump greets Vladimir Putin at Joint Base Elmendorf-Richardson, Alaska. Pic: AP/ Julia Demaree Nikhinson
Image:
Donald Trump greets Vladimir Putin at Joint Base Elmendorf-Richardson, Alaska. Pic: AP/ Julia Demaree Nikhinson

After much build-up to the summit – with the US president threatening “severe” consequences for Russia should it not go well – it was ultimately not clear whether the talks had produced meaningful steps towards a ceasefire in what has been the deadliest conflict in Europe in 80 years.

Mr Trump said he intended to speak with Ukrainian President Volodymyr Zelenskyy and other European leaders, who were excluded from the discussions, to brief them.

Despite not reaching any major breakthrough, the US leader ended his remarks with a thank you, and said he would probably see Mr Putin again “very soon”.

When the Russian president suggested that “next time” would be Moscow, he responded by saying he might face criticism, but “I could see it possibly happening”.

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Trump applauds Putin and shares ride in ‘The Beast’

The red carpet treatment

The news conference came after a grand arrival at the Elmendorf-Richardson military base in Anchorage, where the US president stepped down from Air Force One and later greeted his Russian counterpart with a handshake and smiles on a red carpet.

Mr Putin even travelled alongside Mr Trump in the presidential limousine, nicknamed “The Beast”.

It was the kind of reception typically reserved for close US allies, belying the bloodshed and the suffering in the war.

Before the talks, the two presidents ignored frantically-shouted questions from journalists – and Mr Putin appeared to frown when asked by one reporter if he would stop “killing civilians” in Ukraine, putting his hand to his ear as though to indicate he could not hear.

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‘Fury, anger and disgust’ in Ukraine

Our US correspondent Martha Kelner, on the ground in Alaska, said he was shouting “let’s go” – apparently in reference to getting the reporters out of the room.

Read more:
The moment Vladimir Putin has craved
What we expected from summit – and what actually happened

Trump-Putin summit in pictures
Mapping the land Ukraine could be told to give up

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What we learned from Trump-Putin news conference

A ’10/10′ meeting

During his first day back in the White House in January, Mr Trump had pledged confidently to bring about an end to the war in Ukraine.

But seven months later, after infamously berating Mr Zelenskyy during a meeting at the Oval Office in February, and then stanching the flow of some US military assistance to Kyiv, he still does not appear to have brought a pause to the conflict.

In an interview with Fox News before leaving Alaska, Mr Trump described the meeting with Mr Putin as “warm” and gave it a “10/10”, but declined to give details about what they discussed.

He also insisted that the onus going forward could be on Mr Zelenskyy “to get it done”, but said there would also be some involvement from European nations.

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Trump’s body language was ‘disappointed’

What happens next?

Mr Trump has spoken with Mr Zelenskyy, Sir Keir Starmer and European leaders about the talks.

Following the call, Mr Zelenskyy reiterated the importance of involving Europe: “It is important that Europeans are involved at every stage to ensure reliable security guarantees together with America,” he said.

“We also discussed positive signals from the American side regarding participation in guaranteeing Ukraine’s security.”

In a joint statement, European leaders including Sir Keir said: “We are clear that Ukraine must have ironclad security guarantees to effectively defend its sovereignty and territorial integrity.

“We welcome President Trump’s statement that the US is prepared to give security guarantees.

“The coalition of the willing is ready to play an active role. No limitations should be placed on Ukraine’s armed forces or on its cooperation with third countries. Russia cannot have a veto against Ukraine’s pathway to EU and NATO.”

Despite the US president’s efforts to bring about a ceasefire, Russian attacks on Ukraine have only intensified in the past few months.

On 9 July, Russia carried out its largest aerial attack on Ukraine since the start of the war, launching more than 740 drones and missiles.

Furthermore, Mr Zelenskyy has said Russia is preparing for new offensives.

Ahead of the summit, one of the key commanders of Ukraine’s drone forces told Sky News in a rare interview that there would be no let-up in its own long-range drone attacks on Russia until Moscow agrees to peace.

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