Wed. Apr. 10 2002 11:30 PM
Canadian researchers are ready to go public with an aggressive new approach to treating multiple sclerosis. It's an attempt to re-start an MS patient's damaged immune system, with a whole new immune system.
Researchers at the Ottawa Hospital have successfully transplanted four patients with new immune cells and say they think the process is safe.
Stephanie Rainville-Wray is the first Canadian patient to undergo the radical, experimental treatment.
She was diagnosed six years ago with MS, an auto-immune disease in which immune cells eat away at the nerve fibres. Patients lose vision, balance, the ability to walk and, eventually, to function.
None of the available drugs worked for Stephanie. So doctors at Ottawa Hospital offered her a new approach.
"This was hope for me," Rainville-Wray says. "The possibility that it might slow the disease and possibly even stop it."
Doctors erased her immune system with ultra-high doses of chemotherapy -- the same kinds of drugs used on people with some kinds of leukemia. The treatment itself is so brutal, it's fatal in up to eight per cent of cases.
Once the chemo had wiped out her old immune system, they then injected her with stem cells taken from her bone marrow. The doctors hoped the cells would act as the seeds of a new, and hopefully healthy, immune system.
And now at the six-month mark, the treatment seems to be to be working. On MRI scans, the tell-tale signs of the disease are no longer visible. Three other patients have been treated since Rainville-Wray.
"In four cases, we've had four successful grafts with no evidence of any active disease," says Ottawa Hospital's Dr. Mark Freedman.
Stephanie herself says she doesn't feel any different yet but is hopeful.
"I do not notice any difference yet, I think it's too early. But what I am pleased about it is that the MRI shows there is no active disease. That, in itself, is pretty impressive."
Researchers in the U.S. and Europe have tried this approach on severely disabled MS patients. While it stopped signs of the disease, it didn't completely slow the rate of disability. The Canadian team is the first in the world to try stem cell transplants on much younger and healthier MS patients hoping it would stop the disease before it disables.
So is the treatment a cure? Doctor's don't know.
"The cure in this case would be a listing remission, not requiring any intercession with any more aggressive drugs," explains Freedman. And that could take three to five years before there's a clear answer.
"It's a significant step forward," says Dr. William McIlroy of the Multiple Sclerosis Society of Canada. "But on the other hand, it's a risky form of treatment. So it has to be done in a carefully controlled environment."
The four patients will undergo neurological tests, blood tests each month, so that if the MS does return, doctors can capture its first advances in the immune system, teaching them the mystery of how MS begins. And Stephanie will lead the way.
"I feel pretty privileged," Rainville-Wray says. At the time, it was a hard decision to make. But I have no regrets."