Turning the tide on multiple sclerosis

February 13, 2009 7:35:44 AM PST
Some multiple sclerosis patients seem to have changed the course of their illness. No one is ready to declare it a cure for multiple sclerosis, but Chicago doctors say for the first time they're showing it's possible to not only slow MS but dramatically reverse signs of the disease.

The procedure involves a stem cell transplant. It's risky but for desperate patients it's a choice they're willing to make.

"Just one morning I woke up and I had no function in my legs at all, except for pain," said Christina Mazie, MS patient.

For 12 years, Christina Mazie was in and out of hospitals dealing with the on-again, off-again symptoms of relapsing-remitting multiple sclerosis. Conventional medications weren't working.

Christina had trouble walking, controlling her bladder, even just talking at times became difficult.

"So we were pretty scared. It was a scary thing," said Mazie.

Today, Christina's symptoms are all but gone.

So how can this happen?

In a potential breakthrough procedure, Dr. Richard Burt at Northwestern Memorial Hospital used a dose of Christina's own stem cells to reset her malfunctioning immune system.

"We are talking about reversing neurological deficits rather than just slowing progression of the disease," said Dr. Richard Burt, immunologist, Northwestern Memorial Hospital.

No one really knows what causes MS. But for some reason the immune system goes haywire, attacking the protective covering of nerve fibers in the spine and brain.

Resetting this system is pretty involved. First, a patient has to have their own stem cells extracted. Chemotherapy drugs are then used to destroy the immune system. Then the stem cells are re-injected to create a new immune system.

"I never use the word 'cured' for what we do. But it's clear we have changed the natural history of this disease and for the first time," said Dr. Burt.

It's a risky procedure but Dr. Burt says the approach is less toxic than cancer therapy. That's because the entire bone marrow is not destroyed.

In a small study, the approach was tried on 21 early stage patients, including Christina. An average three years after having the transplant,17 of the participants had significant improvement of their symptoms, 16 experienced no relapse and none had deteriorated.

MS specialists at Rush University Medical Center watched the health of the study participants. They're encouraged but stress it's a therapy that's still unproven.

"The important point here is that it is not the treatment that produced improvement. It is the treatment stopping the disease and allowing the system to repair itself through natural healing," said Dr. Dusan Stefoski, neurologist, Rush University Medical Center. "It's fairly quick because in a matter of weeks we can achieve almost permanent if you will halting of the progression of MS."

Christina says just a few months after the procedure she already felt better. Now, two years since the transplant all of her painful symptoms are still gone.

Doctors aren't sure that's permanent but for now. Christina is content to just enjoy each pain free day as it comes.

"The last relapse I had I was on 32 prescriptions a day and now I take nothing," said Mazie.

Dr. Burt pioneered stem cell transplants for auto immune diseases. He stresses that these results must now be tested in a more scientific and larger study which is now underway. Patients needed for the research must have an early form of the disease and they must be getting no relief from standard medications.

Dr. Richard Burt
Chief of the Division of Immunotherapy
Northwestern University & Northwestern Memorial Hospital
www.nmh.org
312-926-2000

Dr. Dusan Stefoski
Neurologist
MS Specialist
Rush University Medical Center
312-942-5000
www.rush.edu

For those patients interested in participating in randomized trial of the Stem Cell Transplant contact Dzemila Spahovic at: d-spahovic@northwestern.edu.

Details on the study sited in our story can be found online in the January 30th issue and in the March issue of The Lancet Neurology.

National Multiple Sclerosis Society
www.nationalmssociety.org


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