Thursday, April 26, 2012

Stem Cell Therapy: Treatment or Cure for Crohn's?

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
                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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