Medical premiere in Iasi! A patient with acute lymphoblastic leukemia received an innovative treatment with genetically modified cells. The procedure took place at the Regional Institute of Oncology and represents an extra chance at life for all those who no longer have any hope. “CAR-T cell therapy was administered to the patient two weeks ago. Currently, the young woman is discharged, is at home and comes periodically for monitoring”Dr. Angela Dăscălescu, coordinator of the Hematopoietic Stem Cell Transplant department IRO Iasi, told “Adevărul”.
Genetically modified cell therapy, successfully practiced in Iasi. Photo source: archive
Iulia has been in the records of the Oncological Institute in Iași for two years. “She is a very young patient, diagnosed with acute lymphoblastic leukemia at the age of 21. He did chemotherapy, immunotherapy, hematopoietic STEM cell transplantation. However, these procedures did not work. Basically, this treatment with genetically modified cells is her only hope. It is, more precisely, B lymphocytes trained to recognize tumor cells and eliminate them.” explains doctor Angela Dăscălescu.
What is CAR-T cell therapy?
CAR-T therapy (chimeric antigen receptor – T cell) is a new type of immunotherapy that uses the activation or learning of the body’s own immune system to fight in a targeted manner against tumor cells, without affecting healthy cells, as happens with classical treatments ( chemotherapy, radiotherapy). “The procedure consists of harvesting the lymphocytes found in the patient’s blood, cryogenically freezing them in liquid nitrogen at minus 140 degrees Celsius, and sending them to a specialized center abroad. We sent them to Germany. Here, the lymphocytes were genetically processed, then cryogenized again and sent back to Romania, to our center. This procedure can take up to six weeks”said Dr. Angela Dăscălescu.
After they arrived in Iasi, the cells were administered to the patient. However, before this procedure, the patient must follow a course of chemotherapy to prepare his body. “Our young woman followed for three days. As for the treatment administration procedure, it is very simple. The received cells were thawed, brought to the patient’s bedside and administered through an infusion. Everything takes only a few minutes, but the patient remains in the hospital for several days, under observation”, continues the specialist.
The reason? Adverse effects can be severe. “The girl had a difficult period for several days, but there were some reactions that we expected. After a week she was discharged. Now he is fine, he comes for periodic checks, for monitoring”.
The treatment is considered to be a medicine because its reception is done through the hospital’s pharmacy, said Dr. Alexandra Ionete, primary hematologist, for “Adevărul”. “We can even talk about a personalized medicine which, however, after administration produces unpleasant adverse events. Only after the patient gets out of this episode of adverse effects, he can be discharged, he is sent home, but he returns periodically for control. Or, if something unforeseen happens, he could be re-hospitalized for permanent observation.” more Dr. Ionete.
How genetically modified cell therapy works and what chance patients have of beating the disease
When the genetically modified cells reach the blood of the cancer patient, they activate and destroy the tumor cells. “They are cells that are part of the immune system of any person. And which normally should work. In the case of the cancer patient, these cells do not work well enough to destroy the tumor. That’s why they are re-educated, so to speak, to recognize the tumor and fight against it.” states the coordinator of the Hematopoietic Stem Cell Transplantation department IRO Iași.
What is the chance of survival of these patients? The doctor told us that it depends from person to person. “The chance is an individual one depending on the type of disease, the stage of the disease, depending on the types of treatments administered before, etc. But if we were to look at the data from the studies carried out so far, I would say that the chances of recovery can reach up to 60%. But we must know that each person responds to treatment in a different way”. And Dr. Alexandra Ionete, primary hematologist, stated the same thing. “It doesn’t mean that all patients who follow this therapy get cured… But, the treatment gives them an extra chance”.
At the Regional Oncological Institute in Iasi next week, a second patient will also undergo this therapy. “Then we have another patient whose cells we have harvested and we are preparing to send them for processing. And two other patients will also, in the very near future, benefit from this therapy”. Treatment with genetically modified cells is performed only once. “As for the eligibility, it is primarily given by the indications of this treatment. In Romania, they can be treated with genetically modified cells acute lymphoblastic leukemia which people under 25 suffer from and lymphoma”, explained the doctor from Iesa.
The therapy could also be developed for other types of cancer
If Romania is a pioneer in terms of this procedure – at the Fundeni Hospital in Bucharest it has been practiced for only two years – in other European countries the treatment has been carried out for at least seven, even eight years. “It is a step forward in treating this type of cancer, especially when the patient has no other option. It is a very important therapy for patients suffering from these diseases. Moreover, because these therapies are being developed, they will soon be indicated for other forms of cancer as well.” Dr. Angela Dăscălescu told us.
Patients come to the Iași Regional Oncological Hospital from all over Moldova, but not only. “We have a patient, for example, who we are waiting for now and who comes from Botoşani. However, depending on the patient files and available places, we receive patients from all over the country. They also came to our Institute from Cluj, Alba, and Hunedoara. Addressability is very high. We have more patients than we can process. To give you an idea, one day 100 patients can come to us for consultations”, the doctor from Iesa also specified.