REVERSING SCLERODERMA
If a disease threatened your life, but there was a 50 percent chance you would die from the treatment, would you try it? Here is the story of a woman who did.
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This is scleroderma -- a disease that causes the skin and organs to harden as if turning the human body into stone.
Teri Jeansonne nearly died from it two years ago.
Teri Jeansonne
Has scleroderma
"I was in a lot of pain. I was on very strong painkillers. I stayed in bed all the time. I was miserable. When my disease started progressing, it was pretty evident that I didn't have that long."
Doctors Stephen Lindsey and Jay Brooks offered Teri a risky treatment to save her life.
Jay Brooks, MD
Rheumatologist
Ochsner Clinic
Baton Rouge, LA
"We clearly talked to Teri about that, that there is a risk of death from the treatment because of the side effects."
They gave Teri a very high dose of cytoxan -- a chemotherapy drug known to help scleroderma in low doses. In a clinical study, Teri got 10-times the normal dose.
Stephen Lindsey, MD
Rheumatologist
Ochsner Clinic
Baton Rouge, LA
"It kills most of your immune cells except for the resistant cells that are the basic stem cells."
Within two weeks, those basic stem cells became healthy new blood cells, giving Teri a new immune system - and a fresh start.
Stephen Lindsey, MD
"It definitely reversed the disease. It hasn't cured the disease." "To me, she is a miracle because I do believe she was going to die within six months."
Two years later, Teri's skin has loosened, and the damage to her organs has stopped.
Teri Jeansonne
"It's awesome. I wanted my life back, and I'm getting it back."
Her prognosis is uncertain, but Teri and her doctors are optimistic she'll have a long life full of days like this with her family.
Doctor Lindsey says there are less than 20 patients in the U.S. with scleroderma who have been treated with high-dose chemotherapy. About half of these patients showed significant improvement. The other half died. But Doctor Lindsey says these patients would have died with no treatment at all. The procedure is extremely risky and should be only considered as a last resort.
BACKGROUND: Scleroderma is a chronic connective tissue disease that falls into the category of autoimmune rheumatic diseases. Hardening of the skin is one of the most visible manifestations of the disease. According to the Scleroderma Foundation, scleroderma can be mild to life-threatening, and the symptoms vary greatly from person to person. A mild case can become more serious if it is not treated properly. About 300,000 people in the United States are living with scleroderma. About 80,000 to 100,000 have the severe systemic form. Women are three- to four-times more likely to develop scleroderma than men. The onset of the disease is most common between ages 25 years and 55 years old.
WHAT IT DOES: There are ways to treat scleroderma, but there is no cure. According to the American College of Rheumatology, systemic scleroderma is divided into "limited" scleroderma in which skin involvement is limited to the forearms, hands, legs, feet, and face; and "diffuse" scleroderma which can affect the skin over almost any body area. The skin changes are caused by an increase of collagen and other proteins that lead to thickening and hardening of the skin. Internal organ involvement can include kidneys, lungs, heart, gastrointestinal tract, and the vascular system. Stephen Lindsey, M.D., a rheumatologist from the Ochsner Clinic in Baton Rouge, La., says about half of the people diagnosed with diffuse scleroderma will die from it.
HIGH-DOSE CHEMOTHERAPY: Researchers are now studying how well high doses of the chemotherapy drug Cytoxan works for people with severe scleroderma. Cytoxan is already used as an off-label treatment to help some of the symptoms of scleroderma, but the doses used are very small. Dr. Lindsey says, "Normally, we give somebody maybe one gram every month." Now, researchers are giving some patients between 10 grams and 20 grams of Cytoxan intravenously for five consecutive days. Dr. Lindsey says Cytoxan helps by killing most of the person's immune cells, but it leaves the basic stem cells alone. After wiping out the immune cells that have been taken over by scleroderma, the stem cells that stay behind soon start reproducing to re-populate the person's immune system -- giving them a fresh start with a new immune system.
THE RISK VS. THE BENEFIT: The high-dose chemotherapy treatment is extremely risky. Jay Brooks, M.D., from the Ochsner Clinic in Baton Rouge, says, "This is a very difficult treatment, one that has the potential of killing patients. There is a risk of death from the treatment because of the side effects." Dr. Brooks and Dr. Lindsey have treated just one woman with high-dose Cytoxan. Dr. Brooks says, "She has improved dramatically, and the rapid nature of her disease has decreased tremendously, but we don't know what the future holds." Dr. Lindsey believes the woman, Teri Jeansonne, would have died within six months had she not been treated with the high-dose chemotherapy. Two years after receiving this treatment, Teri is doing great. Dr. Lindsey says, "Her skin was so tight. She couldn't open her mouth. She couldn't move her hands. She couldn't walk and within a few weeks things started to soften up and subside. It was amazing to feel and watch and for her. It was amazing to see her body get improvement."
Katherine Voss
Senior Public Affairs Specialist
Ochsner Clinic
1221 South Clearview Parkway
Jefferson,LA 7021
(504) 842-2225
kvoss@ochsner.com
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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