A revolutionary cancer treatment now available in Ireland for the most common form of childhood leukemia gives hope to people with other forms of blood cancer, it was announced yesterday.
AR-T cell therapy works by manipulating the patient’s own cells to attack the disease.
It is now available for children with acute lymphoblastic leukemia attending Crumlin Hospital in Dublin, saving them and their families the trip to the UK.
Children who have exhausted all other options and have undergone CAR-T cell therapy treatment – which has a good success rate – have been shown to go into remission.
It uses the power of the patient’s own immune system to fight the disease.
Professor Risteárd Ó Laoide, Director of HSE‘s Cancer Control Program said it was “essentially a life-saving treatment for those children who have relapsed and have reached the upper limit of treatment options.”
International studies are currently underway to find out whether this “seek and destroy” form of therapy could also treat blood cancers such as myeloma and non-Hodgkin’s lymphoma.
dr Pamela Evans, clinical director of the CAR T-cell service at Children’s Health Ireland (CHI), said yesterday that 55 children are diagnosed with acute lymphoblastic leukemia each year.
The disease accounted for about 25 percent of all cancer diagnoses in children under the age of 15.
“The provision of this therapy in Ireland will simplify the treatment pathway and have a tangible impact on children and young people and their families,” said Dr. Evans.
The treatment works by extracting the T cells from the patient’s blood.
These are then frozen and sent to a lab to be reprogrammed, where they are trained to seek out and destroy the cancer.
Once fully reprogrammed, they are referred to as CAR-T cells.
After receiving chemotherapy, the patient is infused with the CAR-T cells to detect and kill the cancer.
Professor Ó Laoide said the service’s availability here is the culmination of more than three years of collaborative work.
He added that this was “one of the most exciting treatment developments we’ve seen in cancer.”
Treatment requires input from a variety of specialists and services, including immunology and radiology.
Internationally, it is being investigated whether the therapy can treat solid tumors.
The diary Science Translational Medicine has reported early research showing promise in treating ovarian cancer and a brain tumor glioblastoma with more advanced genetic engineering after experiments were conducted in mice.
Doctors are also considering whether treatment could be given sooner rather than as a last resort.
It would mean the patient could be spared rounds of chemotherapy and bone marrow transplants.
Patients must be carefully monitored in the weeks after receiving the infusion.
However, better early detection and refinement of managing side effects has resulted in a significant reduction in complications such as cytokine release syndrome, which is a sepsis-like condition.
However, according to CHI, there is a risk of relapse in treatment and loss of CAR-T cell persistence in the patient, so these factors remain the biggest obstacles.
About half of patients require further therapy, often involving a stem cell transplant.
Creating a personalized product takes time and is not always successful.
To address the problem, the design of CAR-T strategies “off the shelf” is examined.
https://www.independent.ie/irish-news/t-cell-cancer-therapy-at-crumlin-is-bringing-hope-to-children-41594669.html Crumlin’s T-cell cancer therapy brings hope to children