A 12-year-old girl in Ho Chi Minh City, Vietnam, is now stable after receiving a groundbreaking treatment for high-risk B-cell acute lymphoblastic leukemia (ALL). The treatment, known as CAR-T cell therapy, was successfully administered at the Blood Transfusion – Hematology Hospital in collaboration with experts from Taiwan, marking the first such case in Vietnam.
The patient had initially undergone chemotherapy, but the leukemia returned. A subsequent half-matched bone marrow transplant from her father as well failed to provide a lasting remission, leading doctors to explore more advanced options.
CAR-T cell therapy is an innovative form of immunotherapy that modifies a patient’s own T cells in a laboratory to recognize and destroy cancer cells. According to hospital director Prof. Dr. Phu Chi Dung, this represents one of the most advanced and challenging cancer treatments currently available.
More than a year after receiving the CAR-T cell infusion, the patient’s health remains stable, and she continues to receive ongoing care and monitoring at the hospital. This success offers hope for patients with hard-to-treat blood cancers and highlights the potential of personalized medicine.
The therapy offers several advantages over traditional treatments, including fewer side effects, high treatment effectiveness, longer patient survival, and a significant improvement in quality of life. Researchers believe CAR-T therapy has the potential to create a lasting immune response, reducing the risk of disease relapse.
However, the high cost of CAR-T cell therapy remains a significant barrier. The complex production process and need for advanced equipment contribute to the expense. Prof. Dung stated that the hospital is working to establish the infrastructure and train personnel, with support from international experts, to produce CAR-T cells domestically in Vietnam and reduce costs.
CAR-T cell therapy is a type of immunotherapy used for several types of blood cancer. It works by altering a patient’s T cells to become more effective at fighting cancer. Healthcare providers introduce a new gene into the T cells, enabling them to better detect and kill cancer cells. In some cases, CAR-T cell therapy can cure blood cancer, while in others, it helps patients live longer.
Currently, CAR-T cell therapy is an option for treating several blood cancers when other treatments have failed or the condition has returned. These cancers include B-cell acute lymphoblastic leukemia (ALL), diffuse large B-cell lymphoma, follicular lymphoma, high-grade B-cell lymphoma, mantle cell lymphoma, multiple myeloma, and primary mediastinal large B-cell lymphoma.
The therapy relies on understanding how T cells function within the immune system. T cells, a type of white blood cell, monitor the body for invaders, including cancer, by tracking proteins called antigens on the surface of cells. T cells have receptors that can recognize cells with abnormal antigens. When a receptor identifies an abnormal cell, the T cell activates and works to destroy it, also activating other parts of the immune system.
However, T cell receptors don’t always detect cancer cells. This is where CAR-T cells reach into play. Scientists modify a patient’s T cells by adding a gene for a chimeric antigen receptor (CAR), allowing the cells to recognize specific antigens on the surface of cancer cells. The modified CAR-T cells are then grown and multiplied until there are enough to effectively target cancer cells. Once in the bloodstream, the CAR-T cells detect and destroy cancer cells and continue to multiply, providing a long-term supply of cells to target the cancer – a characteristic that has led researchers to call CAR-T cell therapy a “living drug.”
As of now, six CAR-T cell therapies have been approved by the U.S. Food and Drug Administration (FDA) to treat specific blood cancers:
- Tisagenlecleucel (Kymriah®) for treating ALL in children and young adults.
- Brexucabtagene autoleucel (Tecartus®) for treating mantle cell lymphoma.
- Axicabtagene ciloleucel (Yescarta®) for treating certain types of B-cell lymphoma.
- Lisocabtagene maraleucel (Breyanzi®) for treating diffuse large B-cell lymphoma.
- Idecabtagene vicleucel (Abecma®) and ciltacabtagene autoleucel (Carviykti®) for treating multiple myeloma.
The successful implementation of this therapy in Vietnam, shared at the 8th Vietnam Transfusion and Hematology Conference, the 8th Vietnam-France Open Conference on Transfusion Transplantation Cell Therapy, and the 30th Asia-Pacific Blood and Marrow Transplantation Congress in Ho Chi Minh City on September 16, represents a significant step forward in cancer treatment in the region.
