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March 1, 2006 — To lessen the impact of chemotherapy on bone marrow cancer patients, hematologists are recruiting the patients' own immune systems to help. White blood cells are extracted before a bone marrow transplant, treated to up their activity, and injected back after chemotherapy. Doctors hope to test technique on other patients with immune deficiencies, including HIV.
BALTIMORE--A heavy dose of chemo takes a huge toll on cancer patients' bodies, making them weak and prone to infection. Now, a new, life-saving therapy is helping some cancer patients win the war against a deadly disease.
Having bone marrow cancer hasn't slowed down Todd Ewell, but the chemotherapy to fight the disease stopped him in his tracks. "It's kind of like if you had the worst flu in your life for about six weeks straight," he says.
The body's immune system takes a beating from chemotherapy. Patients can't fight off infection or disease, but Todd's body fought back, thanks to a new immune-boosting therapy.
Aaron Rapoport, a hematologist and oncologist at the University of Maryland Greenebaum Cancer Center in Baltimore, says, "What we're seeking to do is to harness the power of the patient's own immune system."
Before a bone marrow transplant, hematologists collect a patient's own immune cells, then activate, or turn on, the cells in a lab. The enhanced cells are injected back into the patient, along with a pneumonia vaccine, jump-starting the immune system. "It will be better able to respond to infections and also be better able to attack and eliminate cancer cells that may remain," Dr. Rapoport tells DBIS.
The new therapy worked wonders for Todd. "It's going fantastic. It's almost like it never happened." His cancer is in complete remission, and now he's focused on rebuilding his life cancer free.
Doctors are hopeful the new therapy could be tested and used to treat other people with compromised immune systems liked HIV patients and the elderly.
AUGMENTED immune cells have made an impressive impact on the survival of people with leukaemia.
Thirteen people with a form of the cancer called multiple myeloma were treated with genetically engineered T-cells, and all improved. "The fact we got a response in all 13, you can't get better than that," says James Noble, CEO of Adaptimmune in Abingdon, UK, which developed the treatment.
Cancers often develop because T-cells have lost their ability to target tumour cells, which they normally destroy. To retune that targeting, a team led byAaron Rapoport at the University of Maryland in Baltimore engineered T-cell genes that coded for a receptor on the cell's surface. They extracted T-cells from each person, then inserted the engineered genes into these cells and re-injected them.
The souped-up cells were better able to recognise proteins called NY-ESO-1 and LAGE-1, found on myeloma cells but not healthy ones. All 13 people also had the standard treatment for multiple myeloma, which boosts white blood cell count.
Three months after the injection, 10 of the 13 were in remission or very close to it - a 77 per cent response rate - and the others showed drastic reduction in their cancer. Standard treatment alone gives a response rate of between 33 and 69 per cent. The work was presented this week at the American Society of Hematology meeting in Atlanta, Georgia.
Only time will tell whether a one-off injection is enough, Noble says. But given the promising results, the firm is treating another 13 people with myeloma and hopes to treat others with different types of cancer. It is also exploring the scope for engineering more T-cell receptors.
The work is encouraging, but a trial that does not include the standard therapy is needed, says Holger Auner, a myeloma specialist at Imperial College London. Adaptimmune says it has plans to do this.
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