The topic of the article describes how modern-day medicine has gone beyond using drugs to treat leukemia, or commonly known as blood cancer. Blood cancer is a condition faced due to uncontrolled/unforeseen abnormalities in the biological nature of a separate group of blood cells within the blood stream, the white blood cell population. Common forms of blood cancer include leukemia, lymphoma or myeloma. Clinical diagnosis will reveal more details on the status of the disease such as they marker-specificity or the different stages of cancer.

Contemporary technology of treating cancer of many forms revolves around the use of adoptive cell immunotherapy (ACT). ACT is where medical personnel employ a patient’s own immune cells as an approach to treat the underlying disease. The immune cells are cultured and enhanced under in-vitro labs conditions are re-infused back into the patient which helps them fight of the cancerous cells. The safest and preferred route of ACT is where the patient’s own blood is taken and treated specifically to augment their immune cell populations, boosting the patients immunological defenses against the spreading cancer, referred to as autologous ACT.

However, blood cancer patients suffer a backlash from this manner of personalized medications as the source of the cancerous disease lies in their own blood. In-vitro use of their blood may unwillingly enhances the cancerous white blood cells together with the normal white blood cell populations, endangering the patients life during re-infusions.

To overcome this, scientist deploy the use of healthy donor blood or healthy white blood cells rather than relying on the patient’s blood. This form of treatment route, known as allogenic ACT, bypasses the risk of re-infusing cancer cells back into patients. Therapies such as allogenic NK cell therapy where NK cells from suitable, healthy donors [1,2] or stem-cell derived NK cells have demonstrated encouraging results in alleviating the symptoms and halting the progression of blood cancers [3]. The more advanced therapy would be CAR-T cell infusions, which is a genetically reprogrammed ACT approach, proven to treat blood cancer up to the terminal stages [4].

However, such forms of “off-the shelf” treatments possess great risk if not done cautiously. Blood donors undergo a stringent screening process which not only weeds out the “non-inclusive criteria’s” but also ensures that the source of blood is from close kin such as siblings, to avoid blood incompatibility during re-infusions. Although clinical data are proving that allogenic ACT show no side effects [5,6], autologous immunotherapies must not be overlooked. Blood processing techniques such as apheresis and prior immune cells (e.g. NK cell, T-cell) purifications steps have shown promising results as they help exclude cancer cells during blood culture and treatments [7,8].    

To summarize entirely, the choice of therapy must be precise for each type of cancer and each patient’s health conditions, instead of a generally accepted method. Personalized therapeutic solutions are a key medical technology in abolishing the plague of cancer. With emerging techniques and medical advancements, ACT may serve as the corner stone in solving diseases more than just blood cancer.

Reference:

1.        Lamb, M.G.; Rangarajan, H.G.; Tullius, B.P.; Lee, D.A. Natural killer cell therapy for hematologic malignancies: successes, challenges, and the future. Stem Cell Res. Ther. 2021, 12, 1–19, doi:10.1186/s13287-021-02277-x.

2.        Berrien-elliott, M.M.; Jacobs, M.T.; Fehniger, T.A. Allogeneic natural killer cell therapy. Blood 2023, 141, 856–868, doi:10.1182/blood.2022016200.

3.        Damele, L.; Spaggiari, G.M.; Parodi, M.; Mingari, M.C.; Vitale, M.; Vitale, C. Cord Blood-Derived Natural Killer Cell Exploitation in Immunotherapy Protocols : More Than a Promise ? 2022, 1–21.

4.        Car, D.; Rev, N.; Oncol, C. CAR T Cells : Engineering Patients ’ Immune Cells to Treat Their Cancers Available online: https://www.cancer.gov/about-cancer/treatment/research/car-t-cells.

5.        Niu, L. Comparison of autogeneic and allogeneic natural killer cells immunotherapy on the clinical outcome of recurrent breast cancer. 2017, 4273–4281.

6.        Karantalis, V.; Schulman, I.H.; Balkan, W.; Hare, J.M. Allogeneic Cell Therapy: A New Paradigm in Therapeutics. Circ. Res. 2016, 116, 12–15, doi:10.1161/CIRCRESAHA.114.305495.Allogeneic.

7.        Levine, B.L.; Miskin, J.; Wonnacott, K.; Keir, C. Global Manufacturing of CAR T Cell Therapy. Mol. Ther. Methods Clin. Dev. 2017, 4, 92–101, doi:10.1016/j.omtm.2016.12.006.

8.        Harrer, D.C.; Heidenreich, M.; Fante, M.A.; Müller, V.; Haehnel, V.; Offner, R.; Burkhardt, R.; Herr, W.; Edinger, M. Apheresis for chimeric antigen receptor T-cell production in adult lymphoma patients. 2022, 9–10, doi:10.1111/trf.17030.