Hematopoietic Stem Cell Transplantation: An Interview with Dr. Richard Burt

Could you please explain the stem-cell procedure that you’re testing?   

We are testing a procedure called hematopoietic stem-cell transplantation (HSCT), but there are a lot of misnomers that can cause confusion for people who are not familiar with HSCT. First, hematopoietic stem cells are immune stem cells. So, perhaps a better term would be immune stem cell transplantation. Second, the word “transplant” can cause confusion. When people hear it they often think of a transplant for cancer and we do not use these cancer drugs; we don’t use radiation or any cancer treatments. Nor does HSCT include transplantation of someone else’s stem cells – we give the patient their own stem cells during the procedure.

We use standard immune suppressant drugs, commonly used to treat immune or autoimmune diseases, in a very short exposure and high dose to knock down the immune system, and then we give you back your own immune stem cells that we have collected before the procedure. Giving back your immune stem cells as a supportive blood product hastens recovery, but they’re not necessary – you’d recover fine without them.

In MS, the immune inflammation that destroys myelin requires two signals to get started, one is exposure to myelin or something that looks like myelin and the second is a danger signal-something that tells the body there is a need for an immune attack. If either of these two signals are missing, you will not get the inflammation that causes MS. In HSCT, we are starting over-resetting the immune system. Think of it like a re-boot of your computer, we are wiping the hard drive clean and starting over. The immune system has to learn all over again which things to fight (pathogens like bacteria and viruses) and which things to leave alone (myelin). We think what happens in HSCT is that the immune response is exposed to myelin in the absence of the danger signal and as a consequence is rendered harmless (tolerant), unable to do any more damage.

Is there a type of MS that is most likely to benefit from HSCT?

Yes, because what we’re doing is stopping inflammation you need to treat when the disease in its inflammatory stage, which occurs in relapsing remitting MS. We don’t think this treatment will be very helpful for people with progressive forms (primary or secondary) of MS. However, there are other forms of stem cell therapy, therapies designed to promote nervous system repair that hold great promise for treatment of all forms of disease, including progressive MS.

Are you still recruiting people for your trial?

Yes we are. The trial is still open and ongoing. You can learn more here.

You mentioned you won’t treat people who are in late secondary-progressive, are there certain types of people that are particularly appropriate or should consider the trial?

The best way to answer that question is where does this approach lie in the treatment of MS? There are first-line therapies such as Avonex and Copaxone. If someone’s MS is controlled well with first-line therapy, they should stick with their current therapy. But if they’re not, and they’re having frequent relapses, they’ll go to second line therapy.

Our randomized trial is looking at people who have failed a first-line therapy and have opted for stem cell transplantation over a second-line treatment. Our goal of the trial is to establish in a randomized trial that this is the proper role for HSCT. Our early data suggests that HSCT does something that second-line therapy has never done: it reverses disability and significantly improves quality of life.

Can you explain the terms myeloabalative and non-myeloablative?

Our procedure is non-myeloablative. Non-myeloablative means that while we are removing much of the immune system with our drug regime, if we did not replace these cells with stem cells, the patient would be able to recover. Myeloablative is a procedure usually reserved for cancer therapy that completely eliminates the stem cell compartment. In this case, the patient would not be able to survive without a stem cell transplant. We feel that the myeloablative approach is too toxic for patients with MS and shouldn’t be used in people with MS.

There are different centers performing HSCT around the world, is the treatment standardized in any way?

I hope that our trial will help standardize this approach when our clinical trial data is published,. We coordinate our trial at a few other centers around the world. The trial is also being run in University of Sao Paulo, Brazil the University of Uppsala in Stockholm, Sweden. It’s just been approved at the University of Sheffield in the UK, and I’m speaking in Sydney, Australia this month, because they want to open a center there as well. It is the same trial run in all locations.

There are people who may not qualify for your trial or who are looking for other options. Is there any advice or caution you’d offer to people as they explore other options?

We have developed certain criteria for accepting patients in our trial based on our experience and understanding how this therapy works. People do sometimes get upset when they don’t qualify and sometimes they seek out other treatment centers.

Of course you can always find someone who doesn’t have our level of experience understanding the limitations of the treatment and who may treat them, and of course that is your right to make your own treatment decisions, but you have to be cautious if somebody doesn’t have limits or say ‘this approach can’t help this subset.’ This is a very powerful technique and just like anything powerful it can be abused. If used the wrong way it can have adverse effects.

In the early development of something like this, experience of the care team is very important. You want to be sure to work with an experienced center that is dedicated to this form of transplantation. This is so promising and so exciting, but it is not without risks.

Could you speak about the side effects and risks that people need to know about?

Someone could die from our therapy, this is most likely to be the result of a runaway infection. We are very good at preventing that, we’ve had no deaths in trial participants with MS. In fact, of the 150 participants I will be reporting soon, we’ve only had one infection. Our procedure is not without risk, but you can minimize it if you follow proper procedures. That highest risk period lasts about eight days while they are recovering in the clinic.

Another risk to be aware of is the potential for infertility. It’s age-dependent and many of our patients have gone on and gotten pregnant even in their 30’s. We encourage people who are concerned about infertility to consider options such as sperm or egg storage prior to the procedure.

Most people get blood transfusions during this process. There is also a small risk of becoming infected with HIV or hepatitis. Again, the risk is very small. In my lifetime, I’ve probably transplanted about 1,500 patients and I’ve never had anyone get HIV or hepatitis from a blood transfusion, but you can never say for sure that there is no risk. Finally, late complications of this procedure unique to MS that may arise in a small subset are hypo or hyperthyroidism, or more rarely a drop in platelets that may require transient medical treatment to reverse.


Richard K. Burt, MD is Chief, Division of Immunotherapy at Northwestern University's Feinberg School of Medicine in Chicago, Illinois. An established international researcher, Dr Burt pioneered the use of hematopoietic stem cells to treat autoimmune diseases.

** Join the conversation about stem cells and MS here. **

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    61 Comments

  • Leanne   Aug 27, 2014 12:01 PM
    I would like to be considered for the trial please.
  • Leanne   Aug 27, 2014 12:01 PM
    I would like to be considered for the trial please.
  • Trudee   Aug 27, 2014 12:02 PM
    Thank you Dr Burt! I've been a part of his study for 5 years now, and I'm one of the 150 transplants he has performed. My transplant was on 9/10/2013. He's changed my life, and I'll be forever grateful. Contacting Dr Burt was one of the best decisions I've ever made!
  • maryann sottilo   Aug 27, 2014 12:13 PM
    i would like to be considered.
  • Diann DeFrank   Aug 27, 2014 12:19 PM
    I have relapsing/permitting M S. I just switched from REBIF to Tecfidera 2 months ago. I am interested in participating in this trial. What is the next step? I live in Harrisburg, Pennsylvania.

    Sincerely,

    Diann DeFrank
  • Jayne Bray   Aug 27, 2014 12:23 PM
    10 years ago I had high dose cytoxin for the treatment of MS. For 10 years I had no relapses until now. Was wondering if I would be a candidate for this procedure?
  • Troy McCall   Aug 27, 2014 12:27 PM
    I would love to participate in this trial
  • Kathy Hahn   Aug 27, 2014 12:28 PM
    I have been on most therapies and they don't work. I have relapsing remitting ms since 2003. Please help me.
  • ebony   Aug 27, 2014 12:32 PM
    I was diagnosed 8/1/08. It was determined that it's RR form of MS. I have 3 kids that I would love to run around and play with! I would like to participate in this study
  • Diana Reisdorfer   Aug 27, 2014 12:48 PM
    I was diagnosed in Feb. of this year with PPMS. Would there be any treatment or for some one like me. I was told that there was't anything that could be done to help me. I don't want to just wait for MS to take over my body and mind.
  • Chad   Aug 27, 2014 1:05 PM
    I would love to be in a stem cell study, how do you go about getting in?
  • Rizwan aslam   Aug 27, 2014 1:20 PM
    I'd like to be considered for this
  • Amanda   Aug 27, 2014 1:41 PM
    I had this done with Dr. Burt in June 2012. I can honestly say he gave me my life back.
  • Avatar
    refusetoquit  Aug 27, 2014 1:43 PM
    I've have PPMS, 16yrs and have been on all meds, currently on Techfidera. In a wheelchair 6yrs. For 2yrs have followed Dr. Wahls Protochol with great improvement's. My concern .............being on an immune suppesant prevents my body's own healing of stem cell's and I am determined to conrinue trying, however. Question, could you suggest treatment's that don't interfere with regeneration of cell's

    I continue to loose abilities monthly even though symptom's are managed. I consider staying on Ampyra and try LDN instead to possibly allow natural body healing. Before heading in to my Neuro I thought I'd run this past you...........it's amazing the idea's that come to mind as I 'walk 'n roll' my dog. She walks, I roll. Thank's in advance!
  • Trudee   Aug 27, 2014 1:50 PM
    Hello!
    There are lots of inquiries on how to get started. If you missed it, there's a link in the article above.
    Also, please remember Dr Burt is studying MS patients with relapsing-remitting MS, and may not be able to help those in progressive stages.
    Here is Dr Burt's website: http://www.stemcell-immunotherapy.com
    You may call his office at: 312 - 695 - 4960
    The email address is: info@stemcell-immunotherapy.com
    There is a Facebook group run by Dr Burt's patients to connect, ask questions, and for support. You can find that here: https://m.facebook.com/groups/460126220670173?ref=bookmark
    If you want to read MY story, my page is here: https://m.facebook.com/profile.php?id=1408007966082845&ref=bookmark

    I hope that gets you all off to a good start!
  • Herbert Leifer   Aug 27, 2014 1:54 PM
    I would like to know more about the study and possibly be considered.
  • Avatar
    Trudee_Manderfield  Aug 27, 2014 2:04 PM
    Hello!
    There are lots of inquiries on how to get started. If you missed it, there's a link in the article above.
    Also, please remember Dr Burt is studying MS patients with relapsing-remitting MS, and may not be able to help those in progressive stages.
    Here is Dr Burt's website: http://www.stemcell-immunotherapy.com
    You may call his office at: 312 - 695 - 4960
    The email address is: info@stemcell-immunotherapy.com
    There is a Facebook group run by Dr Burt's patients to connect, ask questions, and for support. You can find that here: https://m.facebook.com/groups/460126220670173?ref=bookmark
    If you want to read MY story, my page is here: https://m.facebook.com/profile.php?id=1408007966082845&ref=bookmark

    I hope that gets you all off to a good start!
  • Melanie Spears   Aug 27, 2014 3:02 PM
    I would love to try this!
  • Jovan pereZ   Aug 27, 2014 5:14 PM
    I would like to try for the trial I have rrms I am 32 please send me more info
  • Keith   Aug 27, 2014 5:44 PM
    I had Dr. Burt's treatment in December of last year. I can't thank him and his team enough for giving me my future back. For those interested in this treatment, follow the links in Trudee's comment above. I highly recommend following through. One thing that all of us who have been treated have in common is that we all took the time and effort to apply. Good luck
  • Keith   Aug 27, 2014 5:46 PM
    I had Dr. Burt's treatment in December of last year. I can't thank him and his team enough for giving me my future back. For those interested in this treatment, follow the links in Trudee's comment above. I highly recommend following through. One thing that all of us who have been treated have in common is that we all took the time and effort to apply. Good luck
  • Nancy   Aug 27, 2014 5:52 PM
    I am going to Russia in the new year for HSCT. There are many places providing HSCT, just make sure they are legitimate! You need both the chemo and the stem cells, many places offer the stem cell procedures but they are not the same thing as Dr. Burt is offering.
  • Terry   Aug 27, 2014 6:36 PM
    WOULD LOVE TO BE CONSIDER. Have had rrms since 2008. Currently on gilenya.
  • Gina Tiel   Aug 27, 2014 10:43 PM
    Thank you Dr. Burt for providing my son with a transplant, December 2013 and for changing the direction of his MS course. I will be a forever grateful mom! Thank you Chad Pfefer, MD, Portland, Oregon, for leading me to Dr. Burt!
    A special thank you to the Oregon Chapter Leadership of the NMSS for listening to our requests to reach out to Dr. Burt, to raise awareness surrounding HSCT as another treatment option, helping others understand and explore this new paradigm shift in treating MS, and, mostly, for following through.
  • Gina Tiel   Aug 27, 2014 10:45 PM
    Thank you Dr. Burt for providing my son with a transplant, December 2013 and for changing the direction of his MS course. I will be a forever grateful mom! Thank you Chad Pfefer, MD, Portland, Oregon, for leading me to Dr. Burt!
    A special thank you to the Oregon Chapter Leadership of the NMSS for listening to our requests to reach out to Dr. Burt, to raise awareness surrounding HSCT as another treatment option, helping others understand and explore this new paradigm shift in treating MS, and, mostly, for following through.
  • Gina Tiel   Aug 27, 2014 10:47 PM
    Thank you Dr. Burt for providing my son with a transplant, December 2013 and for changing the direction of his MS course. I will be a forever grateful mom! Thank you Chad Pfefer, MD, Portland, Oregon, for leading me to Dr. Burt!
    A special thank you to the Oregon Chapter Leadership of the NMSS for listening to our requests to reach out to Dr. Burt, to raise awareness surrounding HSCT as another treatment option, helping others understand and explore this new paradigm shift in treating MS, and, mostly, for following through.
  • msiss3962  Aug 28, 2014 10:44 AM
    Yes this works I am four years post transplant from Dr. Richard Burt Northwestern Memorial Hospital changed my life I was told by my local Neurologist here in Allentown Pennsylvania that it was crazy and it was snake oil glad I did not listen to him(Lehigh Valley healthcare system).
  • Rob E.Jones   Aug 28, 2014 12:02 PM
    How can I b a part of the trial group?
  • Dan Furner   Aug 28, 2014 1:03 PM
    I would very much ask for your consideration as a subject for this research.
  • sandydefalco  Aug 28, 2014 7:02 PM
    I would like to volunteer for stem cell research! Please?
  • Melinda   Aug 28, 2014 10:41 PM
    I'm four years post transplant. Prior to treatment, I was having attack after attack. HSCT stopped that. No new lesions since. It starts with a simple email saying "I think I might qualify for your study". Dr. Burt and his team are amazing. Join the Facebook group to talk with us who have been through the treatment.
  • wwenzel  Aug 29, 2014 8:57 PM
    Dr. Burt treated me in with chemo and hsct in February 2014. It got me out of a wheelchair and saved my life from a severe Tysabri MS rebound that was attacking my brainstem. Now I'm learning to walk again. The MS has been stopped and I'm no longer on any MS drugs. Thank you Dr. Burt!
  • Jill Conrad   Aug 30, 2014 1:30 AM
    I would like more info. I do qualify, based on what you want.
  • Julianne Hampton   Aug 30, 2014 11:22 PM
    I've lived with MS for about 21 years now. Would LOVE to try a new therapy !
    I've tried several different modifiers, still searching for one that works.
    Please inform me of the steps I need to get things going! With great hope and appreciation. Sincerely,

    Julianne Hampton
    225 755 0441
  • Stephanie Leski   Aug 31, 2014 5:44 AM
    I was 15 when I woke up with a completely numb right leg. It continued to rotate from limb to limb and I am now 35 with mild permanent problem. I'm a mother of two boys I would love the chance to try this?
  • julie   Sep 2, 2014 8:28 PM
    I would like to participate in this study please!
  • julie   Sep 2, 2014 8:28 PM
    I would like to participate in this study please!
  • julie   Sep 2, 2014 8:28 PM
    I would like to participate in this study please!
  • julie   Sep 2, 2014 8:30 PM
    I would like to participate in this study please!
  • Linda Kilcollins   Jun 13, 2015 2:30 PM
    I would love to be in the trials.
    Thank you,
    Linda Kilcollins (414)788-7317 or 788-7299
  • Linda Kilcollins   Jul 4, 2015 1:44 PM
    Would love to qualfy for sudies.
    thank you 414 788-7317 Linda Kilcollins
  • Kevin Cross   Jul 30, 2015 1:26 PM
    I would like to be considered for the trial please and thank you for your fine work!
  • Diane Buttimore   Aug 21, 2015 2:20 PM
    This has been very helpful to my questions. i have Relapsing Remitting MS of which I was diagnosed in 2004. I have had my ups and downs but have managed thru them. I am a white female and just turned 55 on August 6th. I understand that your cut off for the procedure is 55 but am willing to take the risks. I mostly suffer from fatigue and cant get thru a day without Rydalyn or Aderol. My doctor wants me to start a support group because I am a very upbeat person and wont let MS get to me. My saying is....you cant change it so deal with it....now i would like to change it to....you can change it. Please inform me if i am too old to participate in the study.
  • monica marolf   Aug 22, 2015 9:36 PM
    I've had ms 24 years and lupus for about 20 i am on gilenya for a dmd would like to be considerd for hsct 218 838 4170 i live in Brainerd mn
  • monica marolf   Aug 22, 2015 9:36 PM
    I've had ms 24 years and lupus for about 20 i am on gilenya for a dmd would like to be considerd for hsct 218 838 4170 i live in Brainerd mn
  • monica marolf   Aug 22, 2015 9:36 PM
    I've had ms 24 years and lupus for about 20 i am on gilenya for a dmd would like to be considerd for hsct 218 838 4170 i live in Brainerd mn
  • monica marolf   Aug 22, 2015 9:36 PM
    I've had ms 24 years and lupus for about 20 i am on gilenya for a dmd would like to be considerd for hsct 218 838 4170 i live in Brainerd mn
  • monica marolf   Aug 22, 2015 9:37 PM
    I've had ms 24 years and lupus for about 20 i am on gilenya for a dmd would like to be considerd for hsct 218 838 4170 i live in Brainerd mn
  • monica marolf   Aug 25, 2015 10:29 AM
    Pcoulease consider me for the hsct program i live in Minnesota
  • TomLeone   Dec 15, 2015 3:19 PM
    I am searching for a stem cell treatment procedure that I can qualify for. I am 51, have been on tecfidera for 28 months, my vitamin D levels are averaging 60 for over 3-years. I joined Planet fitness in March 2015 and am exercising daily. I use a walker for most of my ambulating. Please contact me if anyone knows of a location that I have not yet discovered.
  • Araceli Tovar   Jan 20, 2016 11:04 AM
    in the interview you mention that there are other forms of stem cell therapy to promote nervous system repair for people with progressive MS. Can you please tell what they are and where they are being conducted? thank you
  • Kishaunna C Innocent   Jan 24, 2016 10:23 AM
    I'm 26 I was diagnosed at 15 in the past three years my symptoms have progressed I would love to be considered for this trial I have been on chemotherapy and most of the MS medications.
  • monica marolf   Feb 6, 2016 11:16 PM
    I have had ms for 23 years i am RR im currently on gilenyna and doing very well i also lupus just curious about your treatment
  • monica marolf   Feb 6, 2016 11:16 PM
    I have had ms for 23 years i am RR im currently on gilenyna and doing very well i also lupus just curious about your treatment
  • monica marolf   Feb 6, 2016 11:16 PM
    I have had ms for 23 years i am RR im currently on gilenyna and doing very well i also lupus just curious about your treatment
  • Eric Woodard   Sep 6, 2016 11:20 AM
    I would like to be considered for the stem cell research I believe it will give me my life back.
  • Donna   Sep 11, 2016 6:07 PM
    What are requirements to be considered for stem cell treatment? I have had RRMS since first symptoms in 1981. Confirmed diagnosis in 1988. I have been on all DMD meds and because of PML risks was removed from Tysabri and Tecfidera so at this time I am awaiting news to start a new treatment. I would like to be considered for stem cell treatment to prevent any further disability and hault progression of my disease. I am mobile.
  • Susan Fryc   Sep 12, 2016 9:41 PM
    I would like to be considered in this trial. Please assist ~ Thank you :)
  • cynthia Shaw   Feb 2, 2017 9:02 AM
    trying to get inerview with dr, burt
  • Rnkdavis   Mar 26, 2017 9:56 AM
    Are these trials still going on, if so how can I be considered for it
  • Auto Injury treatment   Jun 20, 2017 5:46 AM
    Article is owsem,I really enjoy reading this article.