Non Chemo Option for Leukemia from the NIH

Dr.  Weeks’ Comment:  Does your doctor know about allogeneic rapamycin-resistant thymus-derived lymphocyte (T-cell) transplant.

 

NIH researcher introduces possible cure for leukemia

Stef dela Cruz

If only we could put our cancer-fighting cells in a gym, bulk them up with weight training, and transform them into super soldiers, Oh, wait a minute, we could already do that.

Imagine extracting someone else’s cancer-fighting immune cells, soaking them in a drug with antifungal properties for the survival of the fittest, then putting them back in your body. That’s exactly what happens if you undergo allogeneic rapamycin-resistant thymus-derived lymphocyte (T-cell) transplant.

Whew, that’s a mouthful, is it not? Grab some tissue for a possible nosebleed and take a moment to understand exactly how this novel treatment is making waves as the possible cure for blood cancer.

The ultimate battle: strong immunity vs. strong cancer

Leukemia, watch out. You now have a worthy contender in the form of rapamycin-resistant T-cell therapy! Immune cells, given a much-needed “upgrade,” are promising to be as good as, if not better than, chemotherapy and radiotherapy in killing cancer cells.

“To fight strong cancer, you need a strong immune system,” said Dr. Daniel Fowler, senior investigator at the National Cancer Institute. He described the leaps and bounds he and his team has made in cancer research during a leukemia awareness talk organized by the Philippine College of Physicians and the EPCALM Adult Leukemia Foundation of the Philippines.

“We take out the (T-cells of a person’s) immune system, put it in the incubator, then add rapamycin. If a T-cell can tolerate rapamycin, then it’s strong,” Fowler explained.

Goodbye, side effects

This novel way of managing leukemia is making waves because it just might get rid of the undesirable effects of chemotherapy and radiotherapy. “We want to reduce chemo and radiotherapy done to patients, something we now do in clinical trials,” Fowler said.

This T-cell therapy is actually a “reduced-intensity” transplant. “(In conventional leukemia treatment) the toxicity comes not from the stem cell therapy itself, but from the preparation done for the patient,” he said.

“Transplants have a bad name because they can be very toxic. The toxicity (in leukemia treatment) comes from very high doses of chemotherapy and radiation, which prepares the patient for a stem cell (bone marrow) transplant,” explained Fowler.

But in allogeneic rapamycin-resistant T-cell therapy, both chemotherapy and radiotherapy are greatly reduced, thereby minimizing toxic adverse effects. Additionally, it involves not a full engraftment, but a partial one that results in chimerism.

Half-and-half

A chimera is an organism with two sets of cells of differing genes. In the procedure detailed by Fowler, half of the T-cells found in a transplant patient come from his own body, while the other half comes from his donor.

“But you don’t want chimerism for long,” Fowler said. “A patient’s T-cell population after 100 days shoots back to normal, shifting away from chimerism and back to his usual values. You’re getting a transplant that relies on the power of the immune system, not the power of chemo drugs and radiotherapy.”

“Since you’re not taking down (the T-cell count) to zero, you can do the transplant as an outpatient procedure,” Fowler added. “I will save a lot of money while preventing lethality.”

Looking at a cure

“Leukemia is a highly curable disease, and increasingly so,” Fowler emphasized. “The important thing is to accomplish cure in an economic way wherein a patient’s quality of life is maintained.”

Thanks to groundbreaking research, what was once a lethal disease is now something we can fight successfully. “A decade or so ago, leukemia was considered a death sentence,” said Dr. Erlyn Demerre, chairman of EPCALM. “Now, we consider it not the end of the journey, but the start of it.”

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