OKLAHOMA CITY -- CAR-T, an innovative treatment that harnesses the body’s own immune cells to fight cancer, is now being offered at the Jimmy Everest Center for Cancer and Blood Disorders in Children for young people diagnosed with a type of leukemia.
The Jimmy Everest Center, a clinic within OU Children’s Physicians, treats many young people with leukemia. In the pediatric population, CAR-T is specifically for young people up to age 25 who have precursor B-cell acute lymphoblastic leukemia (ALL), an aggressive form of blood cancer. To receive CAR-T, their cancer must have returned or become resistant to treatment.
“CAR-T is a process in which the patient’s own cells are redirected to attack the leukemia cells,” said David Crawford, M.D., Ph.D., who sees patients in the Jimmy Everest Center. “This is a great opportunity because our patients can now be treated with CAR-T at home instead of us sending them to other institutions for the treatment.”
CAR-T stands for Chimeric Antigen Receptor T-cell therapy. Patients being treated with CAR-T first have their blood collected in a process similar to a typical blood donation. White blood cells (which include T cells) are filtered out, and the plasma and red cells are returned to the patient. The cells are then sent to a company that inserts the gene for a chimeric antigen receptor into the T cells, which binds to cancer cells and activates the T cells. This process allows the newly engineered T cells to recognize and attack cancer with remarkable efficiency. Once the CAR-T cells are generated, they are shipped back to the Jimmy Everest Center and given to the patient through an IV, much like a blood transfusion.
Precursor B-cell ALL is the most common childhood malignancy affecting kids from childhood through young adulthood, peaking in diagnoses between ages 3 and 6. Many are cured with chemotherapy and other treatments, but some are not.
“Children who relapse are in the greatest danger,” Crawford said. “For patients who relapse after a stem cell transplant, for example, we previously didn’t have any more options. CAR-T is really a game-changer for them.”
Unlike other types of cancer therapies, CAR-T therapy is a one-time treatment. The T cells remain in the body, prepared to attack the cancer at any time. The therapy carries a risk of complications, such as cytokine release syndrome and neurotoxicity, but patients are closely monitored and seen daily by their physician, Crawford said.
CAR-T is also being offered at Stephenson Cancer Center for adults diagnosed with advanced lymphomas who are not responding to other treatments. Clinical trials are underway to determine if CAR-T can be used to treat other types of cancer in both adults and children.
For Crawford, it is gratifying to offer his patients and families new hope through CAR-T. Even when his young patients respond well to standard treatment, their quality of life is significantly affected. For those who don’t, CAR-T can be a lifesaver.
“I wanted to be in a field of medicine where I thought what I was doing made a big difference, and no place can you feel more like that when the patient faces a certainty of dying without the treatment you give them,” he said. “CAR-T is a breakthrough for our patients.”