Treating Leukemia With Immunotherapy

By:    Medically Reviewed: Tom Iarocci, MD   Published: February 21, 2014

A new investigational leukemia treatment called T-cell immunotherapy modifies a patient’s own T cells, turning them into “serial killers” that attack cancerous cells.

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Chronic lymphocytic leukemia, or CLL, is a type of blood and bone marrow cancer, and like other people trying to fight this disease, Douglas Olson was out of options. Standard treatments like chemotherapy hadn’t worked. Instead of giving up, he eagerly signed up for a clinical trial testing a new type of leukemia treatment.

And it worked.

Called T-cell immunotherapy, this new type of treatment uses a person’s own immune system to attack cancer. For Olson, doctors retrieved his own T cells, a kind of white blood cell, and genetically modified them in the lab before re-infusing them into his body. Once circulating, they became “serial killer cells” that attacked the cancerous cells.

 

More than three years later, Olson, in his 60s, is still in remission. He even ran a half marathon with his son after his recovery. Olson’s own immune system did the work, thanks to some high-tech help.

 

Fighting Cancer With Immunotherapy

About 48,000 new cases of leukemia were diagnosed in 2013, according to the American Cancer Society, and about 23,000 deaths are expected. Researchers working on new types of treatments like immunotherapy — also called biologic therapy or biotherapy — hope the advance will help countless other people with CLL and other types of blood and bone marrow cancer, including acute lymphoblastic leukemia, also known as ALL.

 

And so far, the research is promising. During the clinical trial Olson participated in:

 

  • Fifteen of 32 adults with CLL responded to the investigational treatment, and seven patients went into complete remission.
  • All five of the first adult ALL patients had remissions; the longest lasting more than six months.
  • Nineteen of 22 pediatric patients with ALL had complete remissions.

 

“The idea of using the human immune system to treat cancer has been something people have thought about for many years,” says David L. Porter, MD, director of blood and marrow transplantation at the University of Pennsylvania Perelman School of Medicine and Abramson Cancer Center.

 

This approach, which is still investigational, has possibilities far beyond leukemia, Porter adds.

 

Side Effects of T-Cell Immunotherapy

Like other types of leukemia treatment, there are side effects of T-cell immunotherapy. Patients may experience varying degrees of flu-like symptoms with high fevers, nausea, muscle pain and sometimes breathing problems and low blood pressure.

 

Some patients are admitted to the hospital during this phase for monitoring. Medications to ease the immune system’s inflammatory responses can help as well, Porter says.  

 

Take the Next Steps

Healthy living is a powerful ally, but unfortunately, cancer can be indiscriminant. If you or someone you care for has a relapsed or refractory cancer (standard treatments are not working), there may be other options through clinical trials. Participating in clinical trials can lead to advances in knowledge that will help others, too.

 

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sources
  • Porter D., MD, Jodi Fisher Horowitz Professor in Leukemia Care Excellence and director of blood and marrow transplantation at the University of Pennsylvania Perelman School of Medicine and Abramson Cancer Center. http://www.med.upenn.edu. Interviewed December 2013.
  • Kalos M., et al. “Long-term Functional Persistence, B cell Aplasia and Anti-Leukemia Efficacy In Refractory B Cell Malignancies Following T Cell Immunotherapy Using CAR-Redirected T Cells Targeting CD19.” American Society of Hematology Annual Meeting, New Orleans, Dec. 7–10, 2013. https://ash.confex.com/ash/2013/webprogram/Paper58607.html. Accessed January 2014.
  • Grupp SA., MD, PhD, et. al. “T Cells Engineered With a Chimeric Antigen Receptor (CAR) Targeting CD 19 (CTL019) Produce Significant In Vivo Proliferation, Complete Responses and Long-Term Persistence Without Gvhd In Children and Adults With Relapsed, Refractory ALL.” American Society of Hematology Annual Meeting, New Orleans, Dec. 7–10, 2013. https://ash.confex.com. Accessed January 2014.
  • Porter D., MD, et al. “Randomized, Phase II Dose Optimization Study of Chimeric Antigen Receptor Modified T Cells Directed Against CD 19 (CTL019) In Patients With Relapsed, Refractory CLL.” American Society of Hematology Annual Meeting, New Orleans, Dec. 7–10, 2013. https://ash.confex.com/ash/2013/webprogram/Paper57693.html. Accessed January 2014.
  • Porter D., MD, et al. “Chimeric Antigen Receptor Modified T Cells Directed Against CD19 (CTL019 cells) Have Long-Term Persistence and Induce Durable Responses In Relapsed, Refractory CLL.” American Society of Hematology Annual Meeting, New Orleans, Dec. 7–10, 2013. https://ash.confex.com/ash/2013/webprogram/Paper57239.html. Accessed January 2014.
  • American Cancer Society. “Leukemia.” http://www.cancer.org/cancer/leukemia/index. Accessed January 2014.
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