Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Friday, June 10, 2016

Good News Research on Multiple Sclerosis

"We are not in the business of making money. We are in business to help our patients in Canada. Our health-care system will not allow us to start taking in patients from around the world."
"It has got to be one of the most satisfying things, to be able to actually help people."
Dr. Mark S. Freedman, neurologist, Ottawa Hospital Research Institute, Canadian Stem Cell Foundation
dr. freedman dr. atkins ms research ottawa hospital
Dr. Mark Freedman and Dr. Harold Atkins have worked closely together for the past 13 years on the stem cell clinical trial. (CBC)

"It didn't happen all at once. It was very slow. But you kept getting happier and happier as you saw the improvement over time."
"It's a nice reward for the work. It's a reward for the patients. They put their trust in us and put their lives in our hands. It's a validation of how robust and how important these findings are for the medical community as we move forward."
"[It was the first clinical trial to demonstrate the] complete, long-term suppression of all inflammatory activity in people with MS."
Dr. Harold Atkins, bone marrow specialist, medical director, regenerative medicine, The Ottawa Hospital
"I got married 11 months after my transplant. I walked down the aisle. I danced at my wedding. I was exhausted. But I did it."
"I had holes in my brain. It lit up like a Christmas tree. If you see MRIs of my brain before the transplant and after, I have no enhancing lesions on my brain at all. My images are clear. It's amazing."
"I had no feeling from my chest down. I could barely cut my food. It was scary. [The procedure] was my last shot at living."
Jennifer Molson, 41, Ottawa multiple sclerosis patient
Jennifer Molson, who took part in the 13-year trial, was diagnosed with MS when she was 21 years old.
Jennifer Molson, who took part in the 13-year trial, was diagnosed with MS when she was 21 years old. (CBC)
Jennifer Molson, 21 when diagnosed with multiple sclerosis, saw her life fall apart in stages, leaving her wheelchair-bound and requiring 24-hour-a-day care. She was one of 24 MS patients who agreed to participate in a 13-year research program. Before the therapy Ms. Molson was unable to do anything for herself, she required aid to eat, to shower or to dress. She is completely changed, living a symptom-free life; skiing, driving, working; her pre-MS life returned. "I got my life back", she smiles.

One of the patients taking part in the program did not survive, emphasizing the grave risk involved. "This is the first treatment to produce this level of disease control or neurological recovery" from MS, the prestigious medical-science journal The Lancet stated in a news release. Amazing news for MS sufferers, but qualified somewhat by the following statement from The Lancet: "Treatment related risks limit [the therapy's] widespread use".

MS is no trifling chronic ailment for those unfortunate enough to be diagnosed with it. It is among the most common of chronic inflammatory diseases of the central nervous system, with an estimated two million people worldwide afflicted with its onset and slow destruction of their bodies leading them to early death. And, for the first time, this high-risk therapy has succeeded in not only slowing its advance in test patients, but removing the bodily failures attributed to MS's advance, leaving those fortunate few people with a virtual new life-lease.

What the treatment itself entails is the use of chemotherapy destroying the patient's immune system, leaving it a blank, while following up with transplanting the patient's own blood stem cells back into their bodies, transforming the blank canvas of the immune system to an entirely new one, refurbished by the patient's own stem cells, obviating the usual process of rejection with the use of material from an outside source. The 24 patients who were inducted into the procedure were followed for a 13-year period.

"[Jennifer] was holding her own, and one day she comes in for her visit and she comes in wearing heels", noted Dr. Freedman. "What is this? This is a girl who could barely walk with a cane last time I saw her." Dr. Freedman's three-decade research into multiple sclerosis hadn't quite prepared him for the remarkable changes he would see in other patients as well, informing him and Dr. Atkins exactly how much of a success their innovative protocol has turned out to be.

Dr. Atkins has, during his career, used stem cell transplantation to treat other auto-immune diseases at the Ottawa Hospital. "It didn't happen all at once. It was very slow. But you kept getting happier and happier as you saw the improvement over time", he stated. The success of the program for most of its participants is ample reward for the doctors whose passion is to be able to stem or reverse the ravages of a dreadful disease. 

That success tempered the sorrow of losing a patient to liver failure resulting from the treatment, and where another of the participants required extensive deep care for liver complications. Spurring the doctors to make changes that would result in less toxic reactions to the liver. Overall, the results were so promising and ultimately rewarding that a general consensus was established in the final analysis:
  • That not a single participant experienced a clinical relapse;
  • That there were no new active inflammatory brain lesions that could be detected;
  • That not a single participant required drugs afterward to control the disease;
  • That crucially, 70% of participants experienced a compete cessation in disease progression.
Word gets around of this kind of successful treatment. And communications have gone out to the two researchers from MS patients from around the world, asking to be taken into a treatment program. Because of the risks involved, the treatment is not a blanket solution for everyone. The risk of death through the treatment remains a concern, though the risk has improved from its original status of one-in-ten risk of death.

The treatment is continuing at the Ottawa Hospital. An additional fifteen patients have been accepted and they are doing well. Patients with advanced status and with progressive disabilities are not considered to be optimum candidates for the procedure. Patients who present with early, aggressive MS which is resistant to drugs controlling the condition are seen as ideal candidates for the program. Advances in drugs and technology have helped.

The Ottawa Hospital team of Drs. Freedman and Atkins had their research funded from the MS Society of Canada, living proof that contributing to the work of medical charities who fund research into the conditions they represent can and do produce lasting and important results.

The doctors now have high hopes that the protocol they pioneered, harvesting stem cells from patients' bone marrow, purifying and freezing them, then returning them to the patients once high doses of chemotherapy drugs had neutralized the diseased immune system which had attacked the patients' central nervous system, will become standard operating procedure elsewhere in the world, where warranted.

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