Archive for the ‘adult stem cells’ Category

One Man’s Quest For Adult Stem Cell Therapy

Wednesday, February 27th, 2013
Article Contributor: John Farrell, Forbes Contributor Covering Science and Technology

 

Michael Phelan is the CEO of SevOne. My Forbes colleague Tomio Geron recently wrote about his fast-growing IT company and Phelan contributed a guest post earlier this year at Eric Savitz’s CIO Network.

Phelan also has multiple sclerosis. Frustrated by the limited effectiveness of standard drugs for MS, he decided to try something more radical.

He traveled to a clinic in Panama and had infusions of adult stem cells generated from his own body fat.

It worked so well, he’s going back for another treatment.

After my last post, highlighting some research on the potential adverse consequences of adult stem cell treatments, some readers, including Phelan, protested that such studies represented but a small fraction of the thousands of successful treatments people were getting offshore, and that I was overlooking the patient’s perspective.

I asked if he’d be interested in recounting his own story in more detail. Our Q&A was conducted by email.

Q:   When did you first show symptoms of MS?

A:   My symptoms started 7 years ago, in my late 40s. I’m 56 now.

Q:   I’m assuming you began by seeking standard medical therapy. Can you tell me a bit about this, which drugs, and what led you gradually (or more speedily) to try a stem cell therapy?

A.  I still use standard medical therapy. I have the best Neurologists in Philadelphia, at the University of Pennsylvania Hospital, and Jefferson. I was on Copaxone for 5 years. Last month I started on Gilenya. Unfortunately, the approved, standard drug therapy has not been effective for me. I considered the Tysabri® (natalizumab) risks too high.

Q.   Before going abroad, you attempted to get into some clinical trials here in the U.S. Can you tell me about the clinical trials you registered for–and whether they explained why you did not qualify?

A.   The first:  Stem Cell Therapy for Patients With Multiple Sclerosis Failing Interferon A Randomized Study

The evaluation process is not funded; therefore I paid approximately $10,000 for travel to Chicago, for tests, MRI’s, etc.  The opinion of the investigators was the risk related to aggressive chemotherapy was not worth the potential gain because I was 55 years old, and the MRI evidence did not confirm enough recent disease activity. The treatment is most effective in active, early stages. My stage was questionable.

A second clinical trial: Autologous Mesenchymal Stem Cell (MSC) Transplantation in MS.  The research team is headed up by Jeffrey Cohen, MD, of the Cleveland Clinic’s Mellen Center for Multiple Sclerosis Treatment and Research. I did not qualify because I would be over 55 at the end point. This study is very similar to the treatment that I received in Panama.

Q.   How did you come to learn about the Stem Cell Institute in Panama?

A.   I researched Pubmed, talked to physicians involved in U.S. studies and reviewed conference publications. I first learned about the Stem Cell Institute from Dr. Roger Nocera, author of Cells That Heal Us From Cradle To Grave.

I also noted that the Medical Director of the Stem Cell Institute was published: Non-expanded adipose stromal vascular fraction cell therapy for multiple sclerosis.

 Plus I read and viewed many personal testimonies of patients, such as famous Texas High School football coach, Sam Harrell.

Q.  You mentioned your first treatment at the Institute has helped restore functionality. Could you explain in detail?

A.   I had visual problems for over a year before treatment, including double vision. After my first treatment in May of 2012, my vision problems resolved and I was able to continue driving. My mental and physical energy improved dramatically. I had urinary problems, including urgency and frequency, both resolved after treatment. Plus, I had reduced spasticity, less headaches and improved balance. I went from a 10-minute treadmill, 2mph limit to a 30 minute, 2.5 mph limit.

Q.   What was your experience like at the Stem Cell Institute?

A.  The care I received at the Stem Cell Institute and Hospital Punta Pacifica was excellent. They had a much more personal, detailed approach than I ever experienced in America. It really felt like “care”. The mini-liposuction was done at the Hospital Punta Pacifica in Panama, a Joint Commission International Accredited Johns Hopkins-Managed Hospital.

Q.  Did you consider going to Celltex Therapeutics in Texas–which was discussed this week in Nature?

 A.  I certainly considered Celltex, but was concerned about FDA interference.

This is a big story. Perhaps, the biggest story in our lifetime. We are learning very quickly how the body heals. I’m grateful to have access to treatment. But, this should be available to everyone.

America is way behind. A recent study in Korea applied the same treatment: autologous, fat derived MSCs to Alzheimer’s with unprecedented results.

 We got off track in America because adult stem cells are confused with embryonic stem cells. So, you have religious and financial interests halting progress in America. Adult stem cells can’t be patented, limiting the financial incentive. Plus, there are conflicted stem cell “experts”, whose research is in embryonic stem cells, spreading misinformation about adult stem cells.

As a result, the FDA created a new “minimally manipulated” threshold, which gives them authority over a medical procedure. This is a crime against ill people who can’t afford to travel overseas for treatment. America should be fast tracking this treatment, not slowing the adoption process to the crawl involved in drug approval.

Phelan’s case is a hopeful one. As this week’s issue of Nature points out:

Arnold Caplan from Case, did pioneering work on MSCs [mesenchymal stem cells] and refers to their action as “hit and run” healing. More than 250 MSC trials are ongoing or completed, he told the audience at an October 2012 summit. And even though most of these studies are small and none has led to regulatory approval for widespread use in the United States or Europe, Caplan says that he would use the cells.

“If I had MS, I would be getting this therapy. I’d probably go offshore.”

This doesn’t change the fact that the business is chancy, however. As the Nature article also shows, after $32,000 spent, MS patient Ann McFarlane did not see improvement in her condition and was disillusioned by her interactions with Celltex.

Nature’s editorial in the same issue rightly urges the FDA to find alternative –and less expensive– ways for stem cell trials to be funded and carried out so that more patients like McFarlane and those with less financial resources than Phelan can benefit from the therapies in the near future.

But critics point out that the editorial presupposes that the FDA should be regulating stem cell treatments when it is by no means certain this is the case. “The FDA requirements, designed for products manufactured and sold on a mass scale, can’t be readily satisfied when it comes to treatments that are personalized to individual patients,” said Phelan.

“This is a medical procedure, not a drug.” He cited Former FDA Deputy Director, Scott Gottlieb’s opinion piece last fall in the Wall Street Journal urging the FDA to back off and let the adult stem cell treatment field grow in the U.S. without the heavy hand of federal regulation.

 
Article Contributor: John Farrell, Forbes Contributor Covering Science and Technology 

Successful Surgery and Bone Marrow Cells For Double Amputee

Wednesday, January 30th, 2013

BALTIMORE, MD (CNN) — As reported on Ktla.com

An Army infantryman who lost all four limbs in a 2009 roadside explosion in Iraq has undergone radical transplant surgery that may help him regain use of his arms.

Last month, the 26-year-old, U.S.A infantryman had successful surgery — a rare double arm transplant — at Johns Hopkins Hospital in Baltimore.

“It feels amazing,” Marrocco told reporters Wednesday. “It is something that I was waiting for for a long time, and now that it happened, I don’t know what to say, because it is such a big thing for my life.”

The last thing Marrocco remembers before being hit by an explosion in 2009 was that he was driving an armored vehicle.

When he woke up at Walter Reed Medical Center in Washington, Marrocco was alive, but missing all four of his limbs.

“When it happened, I didn’t remember too much,” Marrocco said.

“I was still alive, so that’s really all that mattered to me at the time.”

Marrocco is one of only seven people in the country to successfully undergo the surgery, and the first quadruple-amputee soldier, according to Johns Hopkins.

The surgery, which took 13 hours and 16 orthopedic and microvascular surgeons from five hospitals — was also the first bilateral arm transplant performed at Johns Hopkins. All of the surgeons volunteered their services; the surgery and rehabilitation costs were paid by the Department of Defense’s Armed Forces Institute of Regenerative Medicine and Hopkins.

The team of surgeons rehearsed the procedure on cadaver arms four times over the past 18 months, said lead surgeon Dr. W.P. Andrew Lee, director of the Department of Plastic and Reconstructive Surgery at Johns Hopkins.

“On his right side we did an above-elbow transplant by connecting the bone, muscles, blood vessels, nerves and skin between the donor and recipient,” Lee said.

On Marrocco’s left side, “in order to preserve the elbow joint, we transplanted the entire donor forearm muscles over his remaining tissues, then rerouted the nerves to the new muscle.”

While Marrocco is doing well, his recovery will be long and risky, the doctor said.

“The nerves regenerate at the maximum speed of 1 inch per month. The therapy will continue for a few years, first at Johns Hopkins, then at Walter Reed. The progress will be slow, but the outcome rewarding.”

Marrocco is taking anti-rejection medication, which can lead to side effects like infection and organ damage. But he’s received an infusion of the donor’s bone marrow cells to further prevent rejection of his new arms.

That infusion allows him to take only one anti-rejection drug instead of the usual three-drug cocktail.

Doctors call his recovery so far remarkable.

“Now, I can move my left elbow,” Marrocco said. “This was my elbow, the one I had before. I can rotate a little bit. This (right) arm is pretty much not much movement at all — not yet at least.

Hopefully, we are hopeful for the future to get some pretty good function out of it, out of both of them.”

Doctors said rehabilitation therapy is an integral part of the healing process. “The next two to three years, Brendan’s full-time job is doing hand therapy, six hours a day, every single day, once nerves grow in,” said Dr. Jaimie Shores, clinical director of hand transplantation at Johns Hopkins. “He’s going to be working very hard.”

Marrocco said he’s up to the task. The thing he’s looking forward to most? “Driving. Absolutely, driving. I used to love to drive and it was a lot of fun for me. So, I am really looking forward to getting back to that. And just becoming an athlete again. One of my goals is to hand-cycle a marathon.”

Lee hopes the new anti-rejection regimen performed on Marrocco will become the new standard of care for limb and face transplants. Marrocco will participate in a anti-rejection regimen study that’s being funded by the Armed Forces Institute of Regenerative Medicine.

For his family, the surgery means moving forward with their lives.

“Our lives have been on hold for the last almost four years waiting for this surgery, getting him through Walter Reed and getting to the point where he was pretty independent,” said mother, Michelle Marrocco.

“And now he will be independent, and when he comes home, he’ll be the Brendan we’ve all been looking for.”

Marrocco’s message to other’s facing similar challenges? Don’t give up hope. “Life always get better. You’re still alive … just be stubborn. Work your ass off.”

Lee agreed. “Advances in medicine are being made every day in different areas, whether it’s tissue transplantation or tissue regeneration,” he said.

“Research is being performed throughout the world with different ways of regenerating tissues and replacing arms, so they should be optimistic, as we are that there will be new treatments and modalities currently not available.”

Marrocco said he’s is very optimistic about his future.

“I just want to get the most out of these arms and just as goals come up, knock them down, and take it as absolutely far as I can. So really, I just want to get to the point that I can be completely on my own and just get back to enjoying life.”

Click the video link below to hear from Marrocco.

http://landing.newsinc.com/ktla/video.html?freewheel=91045&sitesection=ktla&VID=24288272