Stem Cell/Chemo Treatment got me thinking...

[Ian]

As far as I understand, chemotherapy is used in the stem cell trials to kill the immune system so that in essence you can produce a new one that hasn't yet learned to attack the body with needless inflammation.

When people develop a resistence to biologics like Remicade and Humira, it's because the immune system starts to recognize the antibodies and destroys them, right? (if that's wrong then ignore the rest lol).

If that's the case, wouldn't a person who's had chemo produce a new immune system that wouldn't recognise these antibodies? Meaning the biologics would work again if the patient's IBD returns? Just a thought. I don't suppose Doctors are going to start dealing out chemo to everyone who's exhausted their medication options just so they can start all over again, but unless I've misinterpreted something would it work in theory?

 

[effdee]

That's what I picked up on for the treatment, as well. From talking with Mr. Ziggy, it seems that if the patient has a relapse with Crohn's it will be more responsive to treatment since the 'memory cells' (best way I can think to describe it) get wiped out from your immune system. Sounds like a pretty simple (and awesome) concept to be able to make treatments effective again.

 

[hopeful]

You may have a point. But it may be even better than you think. The standard chemo used before the stem cell treatments (for those protocols that use it), is cyclophosphamide.

Now there are 4 published studies (small ones) from Germany and Hungary using cyclophosphamide alone to induce remission in Crohn's. And it works in almost all cases - very quickly too. Now one knows how it works. But it may be resetting something in immune system - although the dose used in these studies is quite low (750mg once a month for 2 - 6 months).

I think this may be a reason that the stem cell trial in the UK for Crohn's has been designed to test cyclo + stem cell vs cyclo alone, because it is possible that the cyclo is what is doing the trick rather than stem cell therapy.

Although you can't argue that stem cell alone also has amazing powers - a very recent Italian study in Crohn's patients showed that.

 

[Ian]

Wow, that's very encouraging. I hope they can do something with all of this very soon!

 

[lamor32twigs]

I can imagine that cytoxan would work in higher doses to completely wipe out the immune system.
It was discovered long ago that high dose cytoxan could treat aplastic anemia without stem cell transplant by causing the body to redevelop its own, hopefully healthy cells.
This is basically what they use pre bone marrow transplant. The transplant itself is just the rescue.

 

[Guest9283]

Ian - you're catching on pretty fast. Yes the chemo can be used in that theory of yours and most likely it would work. If you read the parts in my blog during the next couple days after each chemo, you will see me saying how well my crohns felt. Sure I was beat from the chemo, but felt great crohns wise. The only reason they use the stem cells is to quicken recovery. I don't ever see them using that much chemo without stem cells. If that were done the patient would stay neutropinic for much longer, and you would hold that much more risk. All stem cell transplant patients respond to drugs like they have never had them before(post transplant). I stopped responding to remicade finally. It was a wonder drug for me, the whole 11+ years. I should respond to it now, if I ever needed it.

 

[JJOM]

You may have a point. But it may be even better than you think. The standard chemo used before the stem cell treatments (for those protocols that use it), is cyclophosphamide.

Now there are 4 published studies (small ones) from Germany and Hungary using cyclophosphamide alone to induce remission in Crohn's. And it works in almost all cases - very quickly too. Now one knows how it works. But it may be resetting something in immune system - although the dose used in these studies is quite low (750mg once a month for 2 - 6 months).

I think this may be a reason that the stem cell trial in the UK for Crohn's has been designed to test cyclo + stem cell vs cyclo alone, because it is possible that the cyclo is what is doing the trick rather than stem cell therapy.

Although you can't argue that stem cell alone also has amazing powers - a very recent Italian study in Crohn's patients showed that.

Could you point us to these publications/studies?

I'd love to read them.

 

[hopeful]

Sorry but I am not yet permitted to post links

so go to pubmed.org and search for cyclophosphamide + crohn's - in total there are 4 relevant papers - or contact me by private message with your email address and I can send them to you.

Same for the stem cell paper.