MS responds to high doses of chemotherapy

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Multiple sclerosis responds to high doses of chemotherapy in local study, improving health of five subjects.

High doses of a cancer drug have given multiple sclerosis patient Maureen Kearney her kick-boxing life back.

An oncologist at Stony Brook University Hospital has been using high doses of the chemotherapy drug cyclophosphamide to treat multiple sclerosis. Kearney's symptoms, which left her in a wheelchair or using canes, have virtually disappeared.

"I was so tired of living my life," said Kearney. The 28-year-old woman was diagnosed with multiple sclerosis at 21. Her condition progressed quickly. What started with numbness and tingling in her left hand soon turned into complete numbness on her entire left side. On good days, the Farmingdale woman got around with a cane. Six months after her diagnosis she went on Betaseron, a standard treatment for multiple sclerosis, and gradually regained some strength. She started walking again, finished a master's degree and started teaching.

But every five months a new attack would wipe her out, sending her back into the wheelchair. Last year she was hospitalised four times. The Betaseron seemed to just stop working.

By the time Stony Brook's Dr. Douglas Gladstone met the young woman, she was blind in her left eye, had blurred vision in her right and was shaking and moving slowly with the help of a walker.

Gladstone enrolled a dozen patients into the experimental drug trial with cyclophosphamide, a powerful drug used to treat leukemia and lymphoma. It wipes out the body's immune system, which is exactly why Gladstone suspected it would work in multiple sclerosis. In the disease process, T-cells of the immune system attack the myelin sheath, the insulation around the nerve cells.

The patients enrolled in this study accepted the risks of the chemotherapy, which temporarily leaves them open to any number of infections. The odds of death are one in 100.

"I was willing to face this risk rather than facing a wheelchair in my near future," said Linda Jacobellis, a 54-year-old mother from Rocky Point.

She'd had MS for 16 years when she heard about the experiment. Her condition had progressed to where she had to hold the wall as she walked or she would topple over. Fatigue, also common to the condition, was unrelenting. "Things were looking bad," she said.

The medicine was infused into patients two hours a day for four days. They stayed in the hospital an additional two weeks. And because it wiped out their immune systems, they lived in a sterile environment with little access to the outside world.

"I got back brand new T-cells with no disease," said Jacobellis. "I am so much better, and so happy that no one will have to take care of me. There is no more walking holding the wall. I am stronger. I still have to watch my balance, but it's given me my life back."

Kearney feels the same way. The treatment alleviated her tremors, returned her sight and gave her back her balance. "Today, I can stand with my two feet together, even balance on one foot. I kick-box. I went skiing for the first time in five years. This is the type of life I now lead."

Neither woman has taken any other multiple sclerosis medicines since their infusions.

Results of the study were published this week in the Archives of Neurology.

Gladstone, an assistant professor in the department of medicine, said he has seen similar results with other autoimmune diseases, including lupus.

The multiple sclerosis patients were followed from six to 24 months. No one got worse, and five people actually got better, he said.

While he is happy with the results, "it is not ready for prime time yet," he said. "I'm an oncologist, and I treat multiple sclerosis as aggressively as I do cancer. ... These patients have a miserable quality of life. This helps."

http://www.msrc.co.uk/index.cfm?fuseaction=show&pageid=1076
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