For decades, bone marrow transplants have been an integral treatment for patients with Leukemia and other blood diseases.
And now, researchers at Fred Hutchinson Cancer Research Center may be able to use immunotherapy techniques to make the transplants more effective and prevent patients’ cancers from returning.
In an early trial of the new approach, 12 high-risk patients with acute myeloid leukemia (AML) were given bone marrow transplants. But in addition to the normal procedure, the patients received an infusion of genetically modified T-cells, which came from the same donor.
The T-cells were altered so they can recognize and target the molecule WT1, which is much more common in Leukemia cells than in their non-cancerous cousins. The hope is that these altered T-cells will kill off any cancer cells that remain after the transplant, and eventually prevent a patient from relapsing.
Two years after they received the transplants, none of the 12 patients had relapsed.
The lack of relapse is notable because of the risks these patients faced. Due to genetic factors or elements of their disease, they faced a high chance that their cancer would return. For comparison, the researchers observed that, in a group of similar patients who were given a normal bone marrow transplant, about one-fourth of patients relapsed.
The bone marrow transplant is familiar territory for Fred Hutch. It was pioneered by researchers there in the 70s, led by Dr. E. Donnall Thomas. Thomas won a nobel prize for his work on the bone marrow transplant in 1990.
One of the trial’s leads, Dr. Aude Chapuis, describes the new addition to the procedure in a Fred Hutch video below.
Although these early results are promising, such early data should be taken with caution. Even promising therapies can have unforeseen side effects, and the precise effects of immunotherapies like this one are still not fully understood.
The new technique comes from the lab of Fred Hutch researcher Dr. Phil Greenberg, who is also the head of Fred Hutch’s Program in Immunology and a scientific co-founder of Fred Hutch spinout Juno Therapeutics.
Juno spun out of Fred Hutch in 2013, and has since been working to bring immunotherapy treatments for Leukemia and other cancers through clinical trials. Their most advanced treatment, JCAR015, hit a roadblock last month when its trial was stalled for a second time by patient deaths, casting doubt the future of that particular drug.
A Fred Hutch spokesperson confirmed that the procedure studied in this trial is licensed to Juno for possible future development.
Greenberg and Chapuis co-led the trial with Fred Hutch clinical researcher Dr. Dan Egan, and the trial was supported by funding from the National Institutes of Health and Juno.