HSCT with Professor Richard Burt, MD

In this episode of Living Well with MS -- where we explore topics relating to living a full and healthy life with multiple sclerosis -- we are pleased to welcome Professor Richard Burt as our guest! Professor Burt is a leading expert in hematopoietic stem cell transplantation (HSCT) for autoimmune diseases including MS.
Keep reading for the key episode takeaways and Dr. Burt’s bio.
Questions and Timestamps
02:35 could you introduce yourself and talk a bit about your work with patients with autoimmune conditions in general, and with this podcast in mind, MS in particular?
12:03 What do you think about the idea of flipping the model and offering the most aggressive treatment options to patients first?
16:27 What are the risks of HSCT?
21:18 Can you talk about the costs associated with stem cell transplantation?
24:13 What type of patients respond best to HSCT?
31:16 Do you see a future where doctors are trained in multiple fields and understand the whole picture of autoimmunity?
38:10 If someone’s interested in exploring HSCT, what should they look for in a clinic or physician?
41:47 HSCT has a high upfront cost but how does that compare to being on an MS drug for years or perhaps a lifetime?
53:50 The Dalai Lama wrote the introduction to your book Everyday Miracles, how did that come about?
Selected Key Takeaways
Randomized controlled trial results for HSCT have been very positive
05:12 In a randomized trial, [HSCT] was just hands down much better than any drug. So you know, all the drugs you use for MS they're based on approval for slowing disease activity that is slowing the number of relapses, or slowing the rate of progression of disability but not stopping it or not reversing it. Often you stay on these drugs indefinitely. So a transplant, on the other hand, it was a one-time treatment. And afterwards, you got better, your neurologic disability reverse, nothing else had done that.
It’s important to consider disease trajectory, risks and benefits of stem cell transplants
14:02 MS causes accelerated loss of brain volume that is brain atrophy. Now, unfortunately, as we age, we get brain atrophy and a normal, very low, but normal decline. But once you get MS, that decline, takes a much sharper drop, and so you're losing neural function a lot faster than normal aging. And for some reason, that's not viewed as a sub-acute or semi-emergency situation that you want to reverse. Traditional drugs have mostly just slowed that rate of decline, but it's still faster than what happens with normal aging. So I would think a more aggressive approach up front would be wise but you always have to remember risk-benefit. if we could do a stem cell transplant with zero risk of mortality, I would say absolutely for everybody. But you can't do that right now.
A medical specialty and institute for auto-immunology could help push the field forward
34:20 There are 80 different autoimmune diseases that I can think of offhand. They're all “homeless” in different departments like Crohn's disease that's in gastroenterology, Scleroderma is in rheumatology, and multiple sclerosis is in neurology. They're all separated out in different areas. If there was a better organization, beginning at a federal level with a national institute of autoimmune diseases that supports centers of excellence around the country that would really help this go forward.
More info and links:
Visit Professor Burt’s website www.astemcelljourney.com
Read Professor Burt’s new book on HSCT for autoimmune diseases Everyday Miracles
Check out Professor Burt’s medical textbook Hematopoietic Stem Cell Transplantation and Cellular Therapies for Autoimmune Diseases
Find out more about the StarMS trial in the UK www.sheffield.ac.uk/scharr/research/centres/ctru/starms
Professor Richard Burt’s bio:
Richard K. Burt is a Fulbright Scholar, Professor of Medicine at Scripps Health Care, tenured retired Professor of Medicine at Northwestern University, and CEO of Genani biotechnology.
He endeavored for 35 years, first with animal models then with some of the world’s first clinical trials, to bring the field of stem cell and cellular therapy to the patients’ bedsides. Dr. Burt has published more than 145 mostly first author articles and is the editor of four medical textbooks. He was the principal investigator of a National Institutes of Health (NIH) $10 million multicenter contract to develop stem cell clinical trials for autoimmune diseases. Professor Burt performed America’s first hematopoietic stem cell transplant (HSCT) for multiple sclerosis (MS).
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