MRI Specialist Lymphoblastic Leukemia Cancer Treatment Centers
Acute lymphoblastic leukemia is a cancer of white blood cells typically found in the bone marrow and blood system. Lymphoblasts are immature white blood cells, part of the body’s immune system. When newly formed lymphoblasts begin to grow out of control, this cancer is termed acute lymphoblastic leukemia, or ALL. ‘Acute’ means that the cancer can progress quickly, ‘lymphoblastic’ refers to the type of white blood cell that is affected, and ‘leukemia’ refers to the origin of the cancer being in the bone marrow.
The most common childhood cancer, overall survival exceeds 85%, contrasting with 30-40% survival in adults with ALL. Improved survival is mainly due to decreased relapse, as treating relapsed ALL remains challenging across all age groups. With each subsequent relapse, achieving cancer remission gets harder and harder, and the likelihood of long-term survival decreases. Similarly difficulties are found in treating refractory ALL, with long-term survival rates close to 30%. (Refractory is a term that implies that patients have failed at least one treatment regimen after a relapse.)
It is thus critical that the treatment of primary ALL is as effective as possible, in order to minimize the incidence of relapsed and refracted ALL and the associated lower survival rates.
Targeted immunotherapy is a potent therapy used to treat ALL – collecting and using patients’ own immune cells to treat their cancer. One rapidly emerging approach is called CAR T-cell therapy. T-cells are a type of white blood cell that fights infection by destroying germs directly, or by boosting or slowing the activity of other immune system cells. The therapy involves reprogramming T-cells to identify and destroy cancer cells through tumor-specific antigen recognition.
For the therapy, blood is drawn from patients and T-cells are separated out then genetically engineered to produce receptors on their surface called chimeric antigen receptors, or CARs. These special receptors are synthetic molecules that enable the T-cells to recognize and attach to a specific protein, or antigen, on tumor cells which they then destroy. CAR T-cells are multiplied to millions, and then infused back into the ALL patient where they recognize and kill the cancer cells with that specific antigen on their surfaces. CD19 is the targeted antigen that has been furthest developed in current CAR T-cell therapy research.
CAR T-cell therapy targeting the CD19-specific antigen has proven to be a powerful immunotherapy, showing striking responses as high as 90% for complete remission in children and adults with relapsed and refractory ALL. However, side effects do occur, with the toxic cytokine release syndrome being the most prevalent. The benefits of immunotherapy versus the potential toxicity of CRS need to be managed by the caregiver to ensure the highest chance of survival of the patient.
As new innovations in CAR design and manufacture develop and toxicity management evolves, the potential uses for this therapy will be expanded, as will access.
View the original lymphoblastic leukemia treatment study at this link: Lymphoblastic leukemia is treated with CAR-T cells