Stem cells have been talked about a
lot in recent years. Usually it is in the news when discussing whether or not
stem cells should be funding. These days stem cells are being used to try to
treat various diseases like cancer, heart disease, and even things like
baldness. There are different types of stem cell transplants are well. In
hematopoietic stem cell transplantation stem cells are taken from bone marrow,
blood, or umbilical cord blood and then the patient’s immune system is
destroyed with chemotherapy before the cells from the bone marrow are
transplanted back into the patient. As with any procedure there are risks associated
with doing this. For Crohn’s patients this procedure is seen as what I would
call a last last resort.
The actual treatment using stem
cells for Crohn’s disease has been around since 2001 when Joy Weiss had the
treatment. Weiss was part of study conducted by Dr. Richard Burt and Dr. Robert
Craig of Northwestern University Medical School. The study only looked at 10
patients who had failed every other Crohn’s therapy. Weiss ended up in Crohn’s
remission for the first time in the 11 years that she had it. One thing that
comes to mind is that if patients who are using this a last resort felt better
how would people who have moderate Crohn’s do?
In this
study from 2010 in the Blood Journal Burt and Craig conducted a study in which
they did stem cell therapy on 24 patients and looked at the patients after 5
years. The clinical remission at year one was 91% but then gradually decreased
to 19% by year five. In this 2003
study remission was achieved by 92% (11/12) of patients and after around an
average of 19 month follow up only 1 (8.33%) which happened 15 months after the
transplant. Clearly, more research has to be done to see how effective this therapy
is in the long run. Also safety is a major issue with stem cell therapy which
is why long term studies have to be performed. As I write this around 26
studies are being performed on stem cells for Crohn’s according to
ClinicalTrials.gov
Celegene
a biopharma company in 2010 in a Phase trial showed that experimental stem cell
were 67% (4/6) of patients in the low
dose group showed clinical remission. Patients
who took the lower dose saw more dramatic results than those that took the
higher dose. The study also met its primary safety goal. According to Celegene’s
pipeline it looks as if the treatment is now in Phase II trials. The company is
also using the same treatment to investigate whether or not there is any
benefit for people with multiple sclerosis, ischemic stroke, and rheumatoid
arthritis.
The
future has an uncertain way of arriving. Time will only tell if stem cell
therapy is just a fad or actually can prove worthwhile. One idea might be to
get doctors in these trials to sequence the genes of patients who are getting
the stem cell therapy to perhaps figure out who has a better chance of achieving
remission.
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