A Royal Free patient has become the first in the world to undergo a treatment for leukaemia which she and her doctors hope will save her life.
Joanne Scott, 53, who lives in Kentish Town, London, has been treated with “natural killer cells” from her daughter that were activated in the laboratory before being transfused into Joanne. Doctors believe these activated cells will survive in Joanne’s system and kill the cancer.
Joanne, a fashion designer, was diagnosed with acute myeloid leukaemia (AML) three years ago. She was treated with four courses of chemotherapy but kept suffering relapses, the last a year ago. The treatment of choice in this situation is a transplant from a matched, unrelated donor, but there was none suitable. An autologous transplant – using cells from the patient, which has a 50% success rate - was tried but Joanne relapsed again.
“There was nothing else that could be done,” said Joanne. “But then my doctor suggested this trial and I jumped at it.”
The treatment was invented by the Royal Free team. The team has discovered that patients who achieve remission after chemotherapy develop a type of immune cell called “natural killer cells” which kill any tumour cells left after the chemotherapy treatment. The cells kill only tumour cells, not normal blood cells. They have dubbed these cells tumour-activated NK cells (TaNK) and, having found a way to produce them clinically, are now being funded by the Leukaemia Research Fund to undertake a trial in 15 patients with AML in whom conventional treatment has failed.
In preparation for receiving the cells, Joanne underwent another course of chemotherapy and a single dose of radiotherapy. For her 21-year-old daughter, Tara, it meant cancelling her holiday and being connected to a machine which removed blood from both arms over a period of two to three hours. The cells were then given to Joanne. Less than a week later tests showed that the vital cells had “taken” which doctors hope mean they have started their job of killing any resistant tumour cells.
“It is important to be clear about the aims of this trial,” said Dr Mark Lowdell, who has led the research. “The first is to ensure that the treatment is safe; the second to demonstrate that the cells have established themselves in Joanne’s bone marrow; we will not know whether they are doing their job of killing the resistant cells for some months.”
Joanne’s clinician and principal investigator of the study, Dr Panos Kottaridis, said:
“We hope this form of immunotherapy will enable us to understand a bit better the way modern treatments work and might act as a platform for future studies in this and other types of cancer.
“We hope for positive results, but this is an experimental treatment and we will need enough data before we can draw meaningful conclusions.”
The trial is being sponsored by University College London, who have granted a licence to American researchers planning trials in breast cancer, ovarian cancer and other blood cancers as soon as the Royal Free has submitted the safety data from this first trial.
“I feel very excited about it all,” said Joanne, “But of course I hope it works. Part of me is a bit nervous, but I am a pioneering spirit!”
Notes to editors
1) For further information contact: Soraya Madell, communications manager, Royal Free Hampstead NHS Trust, 020 7830 2963, email@example.com
2) AML is an aggressive, life-threatening disease and is among the most serious forms of adult leukaemia, with a relatively high fatality rate. Most patients require intensive chemotherapy to achieve complete remission and some also must undergo bone marrow transplants. Up to half of patients with AML, even after such intensive treatment, have residual leukaemia cells or experience a relapse. At this phase this procedure is considered experimental and is being studied to determine how useful it may be against AML.
3) The Royal Free Hampstead NHS Trust has around 900 beds and sees about 700,000 patients a year from all over the world. We employ around 4,600 people and have a turnover of about £450m. Our services include a major accident and emergency service, all branches of surgery and medicine, a renal service serving the whole of north London, paediatrics, maternity services, care of elderly people, an adolescent psychiatric service and one of two high security infectious diseases units in the country. We are renowned for our specialist services including liver, kidney and bone marrow transplantation, renal, AIDS/HIV, infectious diseases, plastic surgery, immunology, paediatric gastroenterology, ENT surgery and audiological medicine, amyloidosis and scleroderma. We are a leading cancer centre with a range of specialist diagnostic and treatment services in oncology and haematology and a major neuroscience base with a network extending throughout north London and into the Home Counties. There are associated internationally recognised research and training programmes.