Ottawa doctors to try bone marrow transplants to treat debilitating disease
Thursday 17 August 2000
The Ottawa Citizen
In a Canadian first, Ottawa doctors will soon attempt to use bone marrow transplants to treat multiple sclerosis.
Ottawa Hospital neurologist Mark Freedman and hematologist Harold Atkins have received several million dollars in funding from the Multiple Sclerosis Society of Canada to perform the highly experimental procedure.
More than 50,000 Canadians, and two million people worldwide, live with multiple sclerosis. It's a progressive and sometimes devastating disease of the nervous system that causes a range of symptoms, from numbness and tingling to worsening paralysis.
Dr. Freedman, head of the multiple sclerosis clinic at the Ottawa Hospital, declined to comment on the study until the official announcement is made next week.
But other doctors say the procedure will build on recent successful attempts to use bone marrow transplants to treat other autoimmune disorders such as rheumatoid arthritis and lupus.
Although the exact cause remains a mystery, multiple sclerosis is believed to result when the body's immune system starts attacking the nervous system. The misfiring immune cells start treating the myelin -- the insulating lining of nerves in the brain and spinal cord -- like a foreign invader, gradually destroying it.
Researchers have theorized that it may be possible to kill off the bad cells and replace them with healthy cells that won't attack the myelin.
The Ottawa experiments are expected to involve first destroying the patient's own immune system with powerful chemotherapy-like drugs. Next, the patient's own stem cells -- the cells in the bone marrow that can produce blood cells and immune-system cells -- would be collected, purified by removing the offending cells believed responsible for triggering the MS and then transplanted back into the patient.
The hope is that the stem cells would generate new immune cells that wouldn't launch an attack against the body.
The Ottawa Hospital has been using so-called stem cell transplants to treat rheumatoid arthritis in patients who haven't responded to conventional therapy. Two years after the first transplant was performed, the patient, Jessica Prescott, is off her arthritis medications and working full time.
Before the transplant, Ms. Prescott had to endure cataract operations, gold injections and even emergency intravenous infusions of steroids when none of her joints would bend.
"Her degree of improvement, and the duration is a little better and longer than I would have guessed at," her physician, rheumatologist Dr. Robert McKendry, said yesterday.
Researchers began suspecting years ago that bone marrow transplants -- used successfully for years to treat leukemia and other forms of cancer -- may provide hope for auto-immune disorders, after some patients discovered their rheumatoid arthritis went into remission after they developed cancer and had a bone marrow transplant. Similar remissions have been reported in patients with multiple sclerosis.
But the aggressive procedure carries serious risks. Patient's who have had stem cell transplants for arthritis, for example, have faced a three-per-cent risk of death and serious side effects such as hair loss, vomiting and diarrhea.
Researchers in Greece, Chicago and others centres have been using bone marrow transplants for multiple sclerosis, with varying degrees of success.
But for patients seriously disabled by multiple sclerosis, "anything that gives people hope" is beneficial, said Laurie Cucheran-Morris, individual and family services manager with the Ottawa-Carleton chapter of the MS Society.
There is no known cure. Drugs can help reduce the attacks, but they
don't eliminate symptoms completely. "Some people are willing to do anything"
to get better control of their disease, Ms. Cucheran-Morris said.