HSCT with Professor Richard Burt | S5E25

Welcome to Living Well with MS, where 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 and has been awarded a number of prestigious accolades.

Watch this episode on YouTube here. Keep reading for the key episode takeaways and Professor Burt’s bio.

Questions and Timestamps

02:35 Could you introduce yourself and tell us about your work with patients with autoimmune conditions and MS?

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 tell us 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

Randomised controlled trial results for HSCT have been very positive
05:12 “In a randomised trial, [HSCT] was just hands down much better than any [other] drug. All the drugs you use for MS are 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. A transplant, on the other hand, is a one-time treatment and afterwards, you get better, your neurologic disability reverses, nothing else had done that.”

It’s important to consider the disease trajectory, risks, and benefits of stem cell transplants.
14:02 “MS causes accelerated loss of brain volume, that is brain atrophy. 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 you're losing neural function a lot faster than normal ageing. 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 ageing. I would think a more aggressive approach up front would be wise, but you always have to remember [the] 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 speciality and institute for autoimmunology 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 [which is] in gastroenterology, Scleroderma [which] is in rheumatology, and multiple sclerosis [which] is in neurology. They're all separated [into] different areas. If there was a better organisation, beginning at a federal level with a national institute of autoimmune diseases that supports centres of excellence around the country, that would really help this go forward.”

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More info and links:

• Visit Professor Burt’s website
• 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

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• Connect with others following Overcoming MS on the Live Well Hub
• Visit the Overcoming MS website

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Professor Richard Burt’s bio:

Professor Richard 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 and then with some of the world’s first clinical trials, to bring the field of stem cell and cellular therapy to the patients’ bedsides.

Publishing

Professor Burt has published more than 145 first-author articles and is the editor of four medical textbooks. He was the first Autoimmune Committee Chairperson for the International Bone Marrow Transplant Registry (IBMTR) and was the principal investigator of a National Institutes of Health (NIH) $10 million multicenter contract to develop stem cell clinical trials for autoimmune diseases.

Hematopoietic stem cell transplants

Professor Burt performed America’s first hematopoietic stem cell transplant (HSCT) for multiple sclerosis (MS), systemic lupus erythematosus (SLE), Crohn’s disease (CD), stiff person syndrome (SPS), and chronic inflammatory demyelinating polyneuropathy (CIDP) and published the world’s first randomised clinical stem cell transplantation trials for systemic sclerosis and multiple sclerosis.

Awards and achievements

He has been awarded the Leukemia Scholar of America, the Lupus Foundation of America Fidelitas Award, the van Bekkum Award by the European Society for Blood and Marrow Transplantation, the Distinguished Clinical Achievement Award by the Clinical Research Forum, and the European Group for Blood and Marrow Transplantation Clinical Achievement Award.

Professor Burt was presented in Vatican City, Rome, with the “Keys to the Vatican,” was a speaker at the Festival of Thinkers in Leadership in Healthcare in the United Arab Emirates and chaired the biotechnology session at the Baku Azerbaijan International Humanitarian Forum. Professor Burt was recognised by Science Illustrated for accomplishing one of the top 10 medical breakthroughs for the next 10 years and by Scientific American as one of the top 50 individuals for improving humanity and outstanding leadership.