Like Father, Like Son
"It is an incredible success story," says Isadore Brodsky, MD, director of hematology/oncology at Hahnemann University Hospital, referring to the newly proven treatment for severe aplastic anemia, a fatal bone marrow failure disorder.
It just so happens that his son, Robert Brodsky, MD, assistant professor of oncology and medicine at The Johns Hopkins University School of Medicine, led this ground breaking research. He is also a 1989 graduate of MCP Hahnemann University School of Medicine. The research was a joint effort combining the resources and talent at Hahnemann, Johns Hopkins and the University of Maryland. Dr. Isadore Brodsky, a world-renowned cancer specialist, was a member of the team.
Until now, patients with a diagnosis of severe aplastic anemia (SAA) had a grim prognosis. As in other autoimmune diseases, the body’s immune system goes inexplicably haywire, setting out on a course to destroy itself. In SAA, the patient’s immune system attacks the bone marrow stem cells crippling their ability to make new oxygen-carrying red blood cells, infection-fighting white cells and clot-inducing platelets. The primary blood producing system of the body fails and the patient along with it.
Medical Detective Work
Until now, treatment had meant either bone marrow transplantation, for which only a small number of patients are eligible, or long-term immunotherapy. Dr. R. Brodsky and his research team discovered that the tried and true chemotherapy drug Cytoxan (cyclophosphamide), when administered in a very high dose four-day intravenous regimen, could be used as the treatment for severe aplastic anemia -- for patients not eligible for a bone marrow transplant.
As Dr. I. Brodsky explains -- the impact of Cytoxan is that the marrow stem cells are able to reconstitute the bone marrow and "reboot" the patient’s immune system, allowing it to function normally without any further therapy.
The study, published in the October 4, 2001 issue of the Annals of Internal Medicine shows that 73 per cent of SAA patients in the study were off all medication at two years. And at 50 months, 65 per cent of the patients were in treatment-free remission.
Hope on the Horizon
The successful use of Cytoxan to treat SAA opens the door for a similar cure for the entire array of 80 destructive and disabling autoimmune diseases such as lupus erythematosus, Crohn’s disease, rheumatoid arthritis and neurologic disorders.
The economic good news is that the treatment is relatively inexpensive because Cytoxan has been on the market since the 1950s and is out of patent. "Insurance companies are going to love it, " add Dr. I. Brodsky.
The brilliant work of Drs. Brodsky and Brodsky, along with world-class teams at three major institutions, offers great hope to patients and their families.
The offices of Isadore Brodsky, MD, are located in the hospital. He can be reached at 215-762-7735.