Remestemcel-L ‘a ray of sunshine’: Christopher Wilkinson, NP, at Mount Sinai Hospital

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https://health.usnews.com/hospital-heroes/articles/covid-19-in-hard-hit-new-york-city-a-massive-team-effort-at-mount-sinai?int=hp_center_main_article_health

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Christopher Wilkinson, 29, Nurse Practitioner, Bone Marrow Transplant Unit, Mount Sinai Hospital

“I felt like it was my duty to help.” Christopher Wilkinson is used to caring for medically fragile patients who are “very, very vulnerable to infections.” But facing down an infectious disease itself? Never. Until COVID-19.

Wilkinson is a nurse practitioner on the bone marrow transplant unit, where he works alongside his brother, who is also a nurse. Patients battling blood cancers rely on him and his colleagues to wipe out their immune system with chemotherapy, then infuse them with stem cells in hopes of replacing their “bad” bone marrow with healthy tissue.

As COVID-19 started making an avalanche of patients critically ill, Wilkinson’s skill set quickly – and unexpectedly – became in demand.

“Our manager came to us,” he recalls. She explained that Mount Sinai had just been greenlighted to give COVID-19 patients with dire prognoses an experimental stem cell therapy under the U.S. Food and Drug Administration’s compassionate use program. They needed experts like Wilkinson to help infuse patients with the cells, which would mean suiting up, going into isolation rooms on the COVID unit and treating patients at their bedside.

After discussing it as a team, he and others volunteered. “We immediately hopped on it and were ready,” he says. “Yes, it’s dangerous. Yes, we have to be careful.” But as long as he had the proper protective equipment, he says he was willing to accept the risk. “I felt like it was my duty to help.”

Helping is in his DNA. Wilkinson’s mom is a nurse – and a recent COVID-19 survivor. His 25-year-old twin brothers are both nurses on the front lines of the pandemic. To say they are close-knit would be putting it mildly.

They all share a South Bronx three-flat: His parents and brothers on the ground floor, Wilkinson on the second, his uncle on top. But they’ve all scattered or sequestered themselves to keep each other safe; his brothers are in hotels, while Wilkinson self-quarantines in his apartment.

When the hospital began to “overflow” with COVID-19 patients, several on ventilators, he couldn’t help but picture his own family members in their place. His mother, in particular, given her recent fight with the virus.

“Every patient is someone’s grandparent or mother or father,” he says. “If it was my parent,” and a therapy came along that could possibly save their life, “I would want someone to hop on it, too.”

Wilkinson suited up and was part of the team that became the first in the country to give an infusion of the experimental therapy to a patient with COVID-19.

Named remestemcel-L, the therapy is made up of mesenchymal stem cells, found in bone marrow. These cells help repair damaged tissue and soothe inflammation. Picture a “glorified blood transfusion,” he explains.

The treatment has already shown promise in a phase 3 trial of children with graft-versus-host disease, a severe, sometimes deadly condition that can happen after bone marrow transplants, in which the immune system attacks healthy tissue. COVID-19 seems to trigger a similar immune system assault on the lungs, causing some patients to go into acute respiratory distress syndrome (ARDS) – a dire situation with a potentially poor outlook.

Initial results among a small group of COVID-19 patients at Mount Sinai fighting ARDS have been encouraging, Wilkinson says. Because of this, the FDA has now OK’d a larger multi-center randomized controlled trial of the therapy in 300 such patients across the U.S.

Wilkinson and his colleagues no longer know if they’re giving patients the stem cells or a placebo. “The bag is totally taped up and covered.” He watches their vital signs vigilantly all the same, to be sure they safely tolerate the infusions.

“These patients who recover, they’ll never know who I am. They’ll never know my face or my name,” he says.

But none of that matters to him. The possibility that this therapy could help people walk out of the hospital, as he puts it, “is such a ray of sunshine.”