Study Finds Stem Cell Transplant Not Effective for Crohn’s Disease

A study has found that stem cell transplant is not a viable option for patient with refractory Crohn’s disease. The disease did not stay in remission at the one-year mark, and patients who received stem cell transfers may experience significant toxicity.

The study, the Autologous Stem Cell Transplantation International Crohn Disease (ASTIC) trial, was published in the Dec. 15 issue of JAMA.

“These findings do not support the widespread use of [hematopoietic stem cell transplant (HSCT)] for patients with refractory Crohn disease,” wrote lead researcher Christopher J. Hawkey, FMedSci, from Queens Medical Centre, Nottingham, United Kingdom.

Therefore, if Crohn’s disease can’t be controlled with immunosuppressive medications and lifestyle modifications, removal of the colon and one of several ostomy options continue to be a preferred course of action for many patients.

The ASTIC trial took place from 2007 to 2011 in six European countries. Follow ups were conducted until March 2013. Forty five patients ages 18 to 50 took part. About half of the participants received a stem cell transplant. The results showed no statistically significant differences between patients who received stem cell transplants and those who didn’t.

Even so, the patients who received the transplant were able to stop immunosuppressive drugs during the last 3 months of their trials, and some of the transplant recipients showed improvement in the Simple Endoscopic Score for Crohn Disease. A colonoscopy indicated these patients has endoscopic mucosal healing.

Since the trial resulted in some positive findings, researchers say more study of stem cell transplant in refractory Crohn’s disease is required.

Until that research can be conducted, Crohn’s patients will likely need a surgical intervention to stay healthy. By removing the colon entirely, Crohn’s patients will be healthier and experience an improved quality of life.

Once the colon is removed, patients have several ostomy options to manage waste elimination:

• A traditional ostomy creates a stoma on your abdomen through which solid waste constantly empties into an ostomy bag. You must wear the bag at all times.
• The J-Pouch is an internal pouch made from the small intestine and the anal sphincter muscle. Waste collects in the pouch and you must empty the pouch four to seven times a day.
• The Barnett Continent Intestinal Reservoir (BCIR) is the more convenient type of ostomy. A pouch is made from your small intestine. A intestinal valve keeps the pouch from leaking stool or gas. Several times a day, you must insert a thin tube into the pouch to drain it.

To learn more about your ostomy options, please contact Dr. Don Schiller who specializes in BCIR surgeries.