A team led by two doctors from The Ottawa Hospital has proved that stem cells, used in combination with chemotherapy can halt the progression of aggressive multiple sclerosis (MS) and — in some cases — help patients recover from the autoimmune disease.…
A team led by two doctors from The Ottawa Hospital has proved that stem cells, used in combination with chemotherapy can halt the progression of aggressive multiple sclerosis (MS) and — in some cases — help patients recover from the autoimmune disease.
In a paper published today in the prestigious medical journal The Lancet, Drs. Harry Atkins and Mark Freedman show that bone marrow stem cell transplants can eliminate all signs of damaging brain inflammation by rebuilding a patient’s immune system.
MS occurs when a person’s own immune system attacks the myelin protective sheath that covers nerves, causing inflammation and damage that inhibits communication between cells in the nervous system — the brain and spinal column.
The researchers took bone marrow stem cells from patients with aggressive MS and purified them in a laboratory. After the patients underwent extreme chemotherapy, their robust stem cells were returned to rebuild new immune systems.
The clinical trial involved 24 patients and tracked their progression over several years. According to The Ottawa Hospital’s news release, after the treatment:
- Not a single participant experienced a clinical relapse (zero relapses in 179 patient-years), whereas before treatment, the participants experienced an average of 1.2 relapses per year.
- Not a single new active inflammatory lesion could be detected in the brains of any of the participants.
- Not a single participant required MS-specific drugs to control their disease.
- 70% of participants experienced a complete stop in disease progression.
- The average rate of brain shrinkage, typically a measure that correlates with MS progression, returned to levels associated with normal aging.
- 40% of participants experienced some lasting reversal of such symptoms as vision loss, muscle weakness and balance problems.
- Some participants were able to return to work or school, regain the ability to drive, get married and have children.
In Jennifer Molson’s case, the treatment eradicated all traces of the MS that had taken over her life. Prior to taking part in the study, she was receiving 24-hour care at the Rehab Centre at the Ottawa Hospital, “learning to how to live with my disability.” She had quit her job and could only walk with the help of forearm crutches or a walker. Life in a wheelchair was imminent.
Now free of MS symptoms for more than a dozen years, Ms. Molson has resumed a demanding career and a busy schedule. As she described in the book Dreams & Due Diligence: Till and McCulloch’s Stem Cell Discovery and Legacy, “I downhill ski, I drive a standard. I can skate. I can dance … Am I cured? I like to use that word. They (Drs. Atkins and Freedman) don’t like to use that word. They’re calling it a lasting remission. I’m very lucky. I got a second chance at life.”
While his recovery was less dramatic, Vancouver’s Aaron Prentice said his quality of life is much improved: “I am now five years post-transplant,” he wrote in the Foundation’s Cellections newsletter last year. “I have not had a relapse and no longer require a cane. My gait has improved significantly and continues to do so. My arms are symptom free.”
The Ottawa Hospital, the MS Society of Canada and the University of Ottawa have produced a video about the clinical trial that can be seen here: https://www.youtube.com/watch?v=vW86owclZes&feature=youtu.be
Marjorie Bowman, trial coordinator and advanced practice nurse at The Ottawa Hospital, expressed her admiration for the remarkable “courage and dedication” demonstrated by the trial’s participants. “We thank the patients from across Canada who participated in this clinical trial, as well as their family members,” she said.
The treatment, Dr. Atkins explained in Dreams & Due Diligence, is a variation on the bone marrow ablation that leukemia patients undergo.
“MS is an autoimmune disease where the immune system is attacking a patient’s brain. The simple concept behind our treatment is, ‘Let’s just get rid of the old immune system and put back the seeds, let a new one grow and hope that it won’t learn the same lesson.’
“Because stem cells don’t carry over immunologic memory. That’s really what we have tried to do. We had a track record for doing transplants for leukemia and knew how we could damage the immune system to remove it. We just applied the lessons we learned in care of patients with leukemia and applied them to this new setting.”
Not for everyone
However, the therapy is not for all MS patients.
“It is only used in very severe cases because participants face a significant risk of infection and other side-effects, including death,” Dr. Atkins said in the media release. “The risks are similar to those faced by leukemia patients undergoing this kind of treatment.”
Indeed, one participant in this study died of liver failure due to the treatment and another required intensive care for liver complications. The treatment regimen was modified to reduce toxicity, but all participants still developed fevers, which were frequently associated with infections.
People who are interested in this therapy should speak with their own neurologist, who can request a referral to The Ottawa Hospital MS Clinic or another major hospital with experience in this area. The Ottawa Hospital cannot treat people without valid Canadian health coverage.
While The Lancet paper is focused strictly on the MS patients, Dr. Atkins has also seen some success treating patients with other immunological disorders such as Stiff Person’s Syndrome, neuromyelitis optica and Crohn’s disease.
And Dr. Freedman has gone on to co-lead a new chemo-free MS clinical trial using mesenchymal stem cells. “These cells have been shown, at least in early studies in humans, to repair — period,” he explained recently. “But they happen, at the same time, to have an anti-inflammatory effect. So they may be able to accomplish both things together. Without the need of any chemo, there is very little risk to the people taking it.”
A turning point for MS
Yves Savoie, President and CEO, MS Society of Canada, called publication of the paper “a turning point” in MS care. “What started as a bold idea has translated into a treatment option for people living with highly active, relapsing MS.”
The $6.47 million trial was funded by the MS Society of Canada and its affiliated Multiple Sclerosis Scientific Research Foundation. The research was also supported by The Ottawa Hospital Foundation, The Ottawa Hospital Department of Medicine and Canadian Blood Services.
Today is the official launch of the Canadian Stem Cell Strategy & Action Plan to chart the course for Canada to lead the way in bringing up to 10 breakthrough therapies to the clinic by 2025.…
Today is the official launch of the Canadian Stem Cell Strategy & Action Plan to chart the course for Canada to lead the way in bringing up to 10 breakthrough therapies to the clinic by 2025.
The 10-year Action Plan outlined in a new report Following Through: Realizing the Promise of Stem Cells – A Canadian Stem Cell Strategy & Action Plan (2015-2025) was created by scientists, medical professionals, leaders from major health charities, industry experts and philanthropists. It is backed up by an in-depth study by KPMG and has been endorsed by an international panel of experts. The report explains how Canada can transform health care and reduce suffering and death from cardiovascular diseases, cancer, diabetes, vision loss, spinal cord injury and other devastating conditions.
Multiple sclerosis survivor Jennifer Molson was on hand at a press conference on Parliament Hill to support the Action Plan. Molson has been symptom-free for 12 years after receiving a stem cell transplant in a Canadian-led clinical trial. “I’m living proof of the tremendous potential that exists with stem cell research. I got a second chance at life. This Action Plan will help others like me live free of illness and disease.”
“Canada has always been a leader in stem cell research,” said James Price, President and CEO of the Canadian Stem Cell Foundation. “With this Action Plan and the infrastructure already in place, we have the capacity to transform health care in Canada by helping millions of Canadians through new, life-changing therapies and long-term economic growth.”
Dr. Janet Rossant, head of research at SickKids Hospital, said the time is right for Canada to seize the opportunity to move stem cell science forward: “We are at an incredibly exciting time in science where our research is leading to new treatments and therapies.”
“I’m proud to be a part of this historic coalition,” said Dr. Allen Eaves, Founder and CEO of STEMCELL Technologies Inc. “The Action Plan is ready to move forward and already has received private-sector support. Support from all governments will ensure companies like mine are able to create local jobs and, most importantly, transform stem cell research into tangible products and lifesaving therapies.”
- The Canadian Stem Cell Strategy & Action Plan calls for a $1.5-billion public-private investment over 10 years, including a $50-million average scaled annual commitment by the Government of Canada.
- The Centre for Commercialization of Regenerative Medicine estimates the Canadian Stem Cell Strategy & Action Plan could generate more than 12,000 jobs for Canadians via the growth of existing companies and the development of new enterprises that reach global markets.
- In 2013, more than $200 billion was spent on health care in Canada. Two thirds of that money was used to treat incurable diseases. Stem cell research, cell therapy and regenerative medicine are working towards treatment options for these diseases.
We recently featured the story of Tina Ceroni, a Burlington Ontario athlete whose life was sidelined by a rare, insidious disorder called Stiff Person Syndrome.…
We recently featured the story of Tina Ceroni, a Burlington Ontario athlete whose life was sidelined by a rare, insidious disorder called Stiff Person Syndrome. Thanks to a stem cell transplant, Tina’s fitness career — and her life — is back on track. To show her gratitude, Tina raised almost $37,000 for the Ottawa Hospital’s Stem Cell and Bone Marrow Transplant Program. When she was presented the cheque to Dr. Harry Atkins on Dec. 4th, Tina met with two other young women whose lives have been rescued by stem cell treatments: Jelissa Morgan and Jennifer Molson. Today we share Jelissa’s story.
From nurse to patient and (soon) back again
When Jelissa Morgan’s neuromyelitis optica flared up again in early 2012, she was devastated.
The rare immunological disorder, similar to Multiple Sclerosis, inflames the optic nerve and the spinal cord. Jelissa was losing her vision — she couldn’t read or watch movies and had trouble identifying who was talking to her. Walking was difficult. She had serious bladder and bowel problems and her skin itched. ‘My body was in pain,” she says, “but didn’t know how to express it.”
That flare-up, the worst of a series the young woman had experienced since finishing high school, transformed Jelissa from hospital nurse to hospital patient.
Until then, her doctors had kept the condition under control with Prednisone, a synthetic corticosteroid that comes with a slew of potential side-effects such as weight gain, sleep difficulties and mood swings. Some patients develop a humped back and a moon face. Jelissa had all of those symptoms and more.
A switch to a different drug, called Imuran, proved futile: she was on it when the worst flare-up struck.
“They were running out of medication options. My neurologist said, ‘What do you think about a stem cell bone marrow transplant?’ She knew about Dr. Harry Atkins and the work he was doing with MS patients.”
For the past several years, the Ottawa Hospital’s Dr. Atkins, working with neurologist Dr. Mark Freedman, has been treating MS patients with stem cell bone marrow transplants. In essence, he takes stem cells from patients with the most severe cases of the immunological disease and purifies and fortifies them. The patient then undergoes an extreme course of chemotherapy treatments that virtually annihilates their diseased immune system. The robust stem cells are then returned to them to rebuild a new — hopefully disease-free — immune system.
The process has worked well with about 30 MS patients whose disease progression has been stopped. In some cases, symptoms of the disease have diminished significantly and — in at least one case — disappeared entirely.
Dr. Atkins is also using the procedure for people who have other autoimmune disorders such as Crohn’s disease, Stiff Person Syndrome — and neuromyelitis optica.
Jelissa decided to have the experimental stem cell treatment.
“It’s kind of one of those decisions where you don’t want to wait,” she say. “You don’t know when the next flare-up will be. That last flare-up was so bad. Luckily, I was able to regain a lot of the functions I’d lost. But it’s like rolling the dice. You don’t know what could happen with the next flare-up.”
Jelissa received her stem cell transplant in the fall of 2012. She has been free of neuromyelitis optica symptoms ever since.
“I feel better than I did even before the disease began. I have much more energy. I’m off all my pills for the immune disorder and the transplant meds. I’m looking forward to getting my life back on track. That includes buying a car, moving out of my parent’s house and traveling.”
She is excited about returning to nursing in the next few months, after receiving a series of vaccinations to replace the ones lost during the chemotherapy treatment.
“From a patient perspective, a transplant is a hard thing to go through. But I survived. I feel like it’s given me a second chance at life. ”
She strongly supports stem cell research to help more people with diseases like hers.
“Stem cell research opens up so many possibilities. It’s like opening a door and entering a room and you don’t even know what’s in the room yet. It could mean treatments for so many things. There is so much hope there.”