Monday, February 18, 2019

Control-Alt-Delete a better approach to treating MS

HSCT is a procedure that aims to reset the faulty immune system. Haematopoietic stem cells are taken from your bone marrow or blood before your immune system is taken out with chemotherapy. The cells are then reintroduced into your blood, where they grow into a new immune system that will hopefully have forgotten the ways of the diseased immune system prior to being wiped out and no longer attack your  nervous system. 
While working as a Fellow at Johns Hopkins a doctor noticed that the patients with leukemia he was helping treat needed get their childhood vaccines again because the protection from diseases like the measles and mumps was being lost due to the treatments for their leukemia.  The cells impacted by transfusion treatments seem to lose their memory of the original childhood vaccinations. It was like they forgot. 
The doctor thought maybe we could get the diseased cells in patients with autoimmune disease to lose their memories they would forget to attack the bodies in people with these autoimmune diseases. This reprogramming would require adult stem cells. At first he had to test the concept in animals and quickly received FDA approval to test the adult stem cell therapy on people with Multiple Sclerosis. 
Although this stem cell therapy has not been approved for standard treatment for people with MS it continues to be studied in clinical trials at multiple centers around the world. The hope and the likelihood is that this therapy will become approved as a standard treatment for MS. In the meantime ongoing clinical trials continue and the results have been miraculous. The average person with MS can't get this therapy today as it is not approved and the only way to get this therapy in USA is to get included in a clinical trial and receive the treatment as a participant in a trial. 
There are a lot of people who would love to get the treatment but there are only a small number of spots in the ongoing trials. These trials have strict inclusion criteria and strict exclusion criteria thus making it likely that most will get rejected for inclusion in the trial and the 200 spots quickly disappear. Soon though these restrictions may be lifted and once approved stem cell therapy known as hematopoietic stem cell transplantation (HSCT) may become the standard of care or at least an optional therapy for individuals with MS meeting certain criteria that would make them a good candidate for the treatment. 
The past and current clinical trials done with HSCT have produced results that would make many call this therapy a cure, however the researchers / doctors refrain from calling it a cure at this point because more longterm data is needed. There have been many who have received HSCT and no longer have active disease and no longer require any medication and no longer have symptoms of the disease and have even had their symptoms reversed and eradicated. Some of these patients are not as careful with the word cure and they in fact joyfully consider themselves free of MS and cured. Many of these patients have been MS free for 5+ years after receiving HSCT. There are some who received HSCT 10 - 15 years ago in the early days of research who are still disease free. 
There are stories that are common for those who have been lucky enough to get HSCT.  One such example is a patient recently shared with journalists that he was diagnosed with Multiple Sclerosis, which is considered a type of autoimmune disease that attacks the brain and spinal cord. Before his adult stem cell treatment, could barely walk.  Today he is a healthy, active husband and father who coaches hockey and lives life to the fullest and has had no signs of active MS on all of his followup appointments since receiving HSCT. 
Here is a link to the recent clinical trial published in JAMA on January 15, 2019.

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Ivy gave MS the boot now there is an updated article woot woot!

 A follow up article on Ivy and her HSCT treatment was just released online and will be printed in Monday’s 5/17/21 Chicago Tribune newspape...