Innovative Transplant Offers Hope for Patient with Rare Autoimmune Disorder
As a career military man, Chris Ryals was used to being physically active. The Air Force master sergeant regularly ran, visited the gym and lifted weights. But in early 2017, he was diagnosed with latent tuberculosis and started on oral medication. Soon thereafter, he began experiencing pain in his feet. He knew something was amiss.
"My feet would be killing me. It would hurt to walk," recalls Chris. Then the pain moved to his knees and shoulders, and Chris' ligaments and tendons were seemingly always tight.
Military doctors diagnosed Chris with scleroderma, an autoimmune disease that affects multiple systems in the body, including the skin, lungs and gastrointestinal track. Scleroderma causes progressive disability and in some cases death. Although rare, the disorder is more common in certain populations, such as African Americans, but it can affect any ethnic group.
"Unknowingly, the latent TB (tuberculosis) medication had caused this seemingly dormant condition to rear its ugly head," says Chris, who was 39 at the time.
"I'll never forget talking to the rheumatologist, and she was telling me what comes along with the condition. I just remember looking at her, and then I sat back and repeated the basics of it: 'So I have a condition that has no cure. And it could potentially kill me.' It was a shock," says Chris, a father of two young children who lives in Brunswick, Georgia.
A downward spiral
Over time, Chris' condition worsened. "I dropped a significant amount of weight. I started to have skin discoloration all over my face, and I was always cold. It got to the point where I was unable to reach for things in the cabinet. It was difficult to do daily activities, like reaching down to put shoes and socks on," says Chris.
In December 2019, at the suggestion of family members — who "always praised the service and quality of Mayo Clinic health care" — Chris traveled south to meet with Andy Abril, M.D., a rheumatologist at Mayo Clinic in Florida.
"When Chris came to see us, his scleroderma was rapidly progressing. So he came to see what alternatives we had for the treatment. Unfortunately, with this condition, there are not a whole lot of options," says Dr. Abril.
One area of innovation though is autologous bone marrow transplantation, where a patient’s own healthy stem cells are used to replace diseased or damaged bone marrow.
Chris had heard this type of transplant was being investigated for patients with autoimmune disorders. But he says he was still shocked when Dr. Abril recommended he visit with a hematologist.
"Autoimmune disorders target people at the most productive stage of life, usually within age 20 and 40, so they have a huge impact. They are complex and difficult to treat in that there are many patients who fail to respond. But bone marrow transplantation, or cellular therapy, has emerged as a powerful alternative to treat these disorders," Dr. Ayala explains.
"In the southern United States, Mayo Clinic is the only center that is offering this type of treatment as standard of care for patients with severe autoimmune disorders," Dr. Ayala adds.
Chris was admitted to the hospital in April 2020. In less than a week, he received his transplant.
Recovery has been slow but well worth the wait, Chris says.
In the eight months since his transplant, Chris has seen his symptoms almost reverse. He's back at the gym, his skin has softened, and much of the discoloration on his face has resolved. Gastrointestinal issues also have abated. "I'm hoping to regain weight and strength in the next six months and beyond," Chris says.
"It's so exciting to see the results of our work. I can see a family together again as a whole, raising their children, going back to work. And to me, it's like the prize of what we do," says Dr. Ayala.
Learn more about ...
Breakthroughs in patient care
One of the ways Mayo Clinic fulfills its core value — to put the needs of the patients like Chris first — is to focus efforts on timely, accurate diagnoses and effective treatments that center on the individual instead of the disease.
Mayo Clinic’s discoveries in novel therapeutics and advanced diagnostics ensure delivery of accurate diagnoses and the effective, personalized therapies and cures patients need. A main pillar of Mayo Clinic's vision is to identify and rapidly advance disruptive approaches that will revolutionize patient care in ways that no one else can.
To accelerate this vision, Mayo Clinic’s novel therapeutics and advanced diagnostics research is focused on high-priority areas of need. Some examples include gene therapy, microbiome-based diagnostics and therapies, cellular engineering, and neuromodulation. Each area supports work across a spectrum of diseases and will ensure multidisciplinary teams move quickly and effectively in pursuit of the organization's patient-centered mission.
It is more important than ever that Mayo Clinic leverage its tremendous advances in scientific knowledge toward novel treatments and advanced diagnostics for patients. No other organization can approach the future of medicine the way Mayo Clinic can — by pairing teams of clinicians and scientists, leveraging the latest technologies, and building from its unique patient-centered model to lead breakthroughs in patient care.
Chris’ experience is the kind of outcome that is driving Mayo Clinic to expand. Ambitious construction projects across Mayo Clinic’s major campuses in Florida, Arizona and Minnesota are providing the expertise, space and technology to deliver new answers to patients and revolutionize the future of medicine. And in Florida, cancer care and related specialties are some of the top priorities for growth.
"In the last few years, Mayo Clinic in Florida has invested significantly in people, technology and space to be able to lead the treatment of solid tumors and hematological cancers, but also to lead in the development of cutting-edge cellular therapies for other diseases, such as autoimmune diseases and neurological diseases," says Roxana Dronca, M.D., chair of the Division of Hematology and Medical Oncology at Mayo Clinic in Florida.
"Seeing the success of this patient gives me hope that we can continue to advance the medical field and make a difference in the lives of patients, not just with cancer, but with other rare and incurable diseases," Dr. Dronca says.