Two people with leukemia achieved remission for more than a decade after receiving an infusion of CAR-T cells. Immune cells that had been modified in a laboratory, according to a new study. The findings suggest this approach could be a long-term therapy for leukemia, with some researchers describing it as a possible cure.
Chronic lymphocytic leukemia accounts for about a quarter of new leukemia cases
Chimeric antigen receptor or CAR-T cell therapy may be a “curative regimen” for chronic lymphocytic leukemia, according to the researchers, who announced their findings at a news conference this week. Chronic lymphocytic leukemia accounts for about a quarter of new leukemia cases.
The new paper describes “a 10-year follow-up of the first patients we treated with CAR-T cells, chimeric antigen receptor-modified T cells.” Which is the “first cell therapy made from the patient’s own immune system,” Dr. Carl June, a cancer immunologist at the University of Pennsylvania and one of the authors of the study, in the informative session.
Based on the study results, “we can now conclude that CAR-T cells can actually cure leukemia patients,” June said.
CAR-T cells are an immunotherapy treatment designed to treat leukemia by harnessing the body’s own immune system to fight cancer. The therapy sends a patient’s immune cells to a laboratory to be genetically modified using a virus. And it gives cells the ability to recognize and kill the source of the cancer.
‘sustained remission’
The new study, published Wednesday in the journal Nature, describes two distinct phases that the patients went through. They had an initial phase represented by CD8+ or CD4-CD8 CAR-T cells expressing a marker called Helios and then a switch to a long-term remission phase dominated by the CD4+ CAR-T cell population.
“CAR T cells remained detectable more than ten years after infusion, with sustained remission in both patients,” the researchers wrote.
The researchers, from the University of Pennsylvania and the Novartis Institute for Biomedical Research in Cambridge, Massachusetts, studied long-lasting T cells in the two people with leukemia who were in complete remission in 2010 after having the cells infused as part of a phase 1 clinical trial. Both remain in remission more than 10 years after infusion, researchers noted
This type of immunotherapy can have serious side effects
Study author oncologist Dr. David Porter said this type of immunotherapy can have serious side effects. He though he said these therapies have become safer over the years and are given to hundreds or thousands of people a year.
One side effect is tumor lysis syndrome, “a phenomenon where you kill a large number of cancer cells at the same time and they spill their contents into the blood, and that can make people quite sick,” he said. Tumor lysis syndrome can cause electrolyte abnormalities and kidney damage.
Another side effect is cytokine release syndrome, which causes a severe flu-like syndrome with very high fever, nausea, vomiting, and muscle and joint pain.
“It can progress to very dangerously low blood pressure, shortness of breath with fluid leaking into the lungs,” Porter said.
The third main side effect is neurological toxicity, which causes difficulty speaking or thinking clearly. In some situations, people can slip into a coma or develop seizures, according to Porter, but most cases resolve on their own.
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