Bone marrow transplant case study

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Bone marrow transplant case study

Postby dignan » Thu Jul 12, 2007 8:44 am

Very interesting, keeping in mind this is about a single case.



Failure of allogeneic bone marrow transplantation to arrest disease activity in multiple sclerosis.

Mult Scler. 2007 Jul 10;
Jeffery DR.
Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Multiple sclerosis (MS) is thought to be an autoimmune disease in which activated T-cells initiate a macrophage mediated destruction of CNS myelin. Bone marrow transplantation (BMT) is currently being evaluated in the treatment of MS in patients with aggressive disease activity. Autologous BMT could potentially reset the immune response to myelin antigens leading to immune tolerance and decreased disease activity. Allogeneic transplantation could reconstitute the immune system potentially arresting the progression of autoimmune disease.

The purpose of this paper is to report a patient with MS who underwent allogeneic BMT for chronic myelogenous leukemia (CML) and showed continued evidence of active demyelinating disease by clinical and radiologic criteria over a period of two years. While this is only a single case report with inherent limitations, it suggests that the immune mediated destruction of CNS myelin in MS may not be prevented or aborted by immune system reconstitution, and is consistent with the idea that immune mediated tissue destruction in MS could be targeted against an abnormal antigen.

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Postby TwistedHelix » Fri Jul 13, 2007 5:55 am

Hello Dignan,
If I've understood this correctly, this is saying that the immune system was not at fault, but was behaving completely normally. It only attacked because it detected antigens presented by body tissues which were shouting " attack me!". This is why rebooting the immune system had no effect because there was nothing wrong with it in the first place.
I am neither pro- nor anti-any autoimmune theories with regard to MS: I just listen to the evidence. This is a very interesting piece, even if it does use just one example,
Dom
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Postby HarryZ » Fri Jul 13, 2007 8:50 am

TwistedHelix wrote:If I've understood this correctly, this is saying that the immune system was not at fault, but was behaving completely normally. It only attacked because it detected antigens presented by body tissues which were shouting " attack me!". This is why rebooting the immune system had no effect because there was nothing wrong with it in the first place.
I am neither pro- nor anti-any autoimmune theories with regard to MS: I just listen to the evidence. This is a very interesting piece, even if it does use just one example,


In the past few years, the docs have used Novantrone, Cyclophosphomide (?) and some other very potent immune system altering drugs in an attempt to help MS patients. Initially, there have been some positive results as the patient reacts to these very powerful drugs but then the disease appears to march on regardless.

They have gone the bone marrow transplant route as well with pretty much the same results. This particular patient got nothing out of it although you wonder if the leukemia had something to do with it.

Makes you wonder just how many more immune system altering drugs or transplant procedures are going to be tried.

Harry
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