Re: New Leukemia Treatment Exceeds Expectations.

[Guest guest]

I just heard a report on this on NPR and after reading this

article I am very excited. Is this too much to believe in,

too good to be true? I would love to hear from our experts

out there, Dr Furman, Dr Hamblin and any others.

R

Atypical CLL Dx 11/05. W & W

Jim wrote:

/message/15725

[Guest guest]

Hi CLL friends,

Hate to be a pessimist here..... But, personally surprised

by all the attention here with this new TX. Just saw it on

the national news and several family members have called

me. Lets be happy but we may want to be guarded as well.

Consider this:

First as an advocate for new drug developement, as good as

this tx could be, it will be years before it becomes

widespread available. Many of us will die before the FDA

allows its use. Even if this tx is as great as the news

coverage is currently painting it, (I'm skeptic) those of us

most in need will not see it. please check out the web site

http://givepatientsafightingchance.com

Second. this drug strategy attacks healthy B-cells just like

Rituximab does. Thus, it will/may have some pretty serious

downsides. Maybe/maybe not it will be as successful as

Rituximab has been. tough to say with only 3 patients

tested. I believe I am alive today only because of

Rituximab. thus, lets get it developed ASAP if indeed it is

this great and safe at the same time.

What is exciting way way way down the road is that this same

technology maybe/possibly/hopefully can be used to attack

specific cancerous targets that are specific to the

cancerous B-cell and not the healthy B-cell. Pretty neat

stuff but years from being around I'm afraid. I guess from

that perspective it justifies some news coverage. Thus, yes,

reason to be optimistic towards the future. How I wish this

as so many of the other new stuff could become available

sooner. Especially for those with no time left.

Sincerely,

Leo

[Guest guest]

This clinical report is very exciting for a number of reasons.

First, I do want to emphasize that it is a clinical report.

Not a clinical trial designed to prove efficacy.

The strategy used here is not novel, but very noteworthy for

being able to overcome some of the previous hurdles others

have encountered with gene therapy. The investigators

removed a patient's T cells and inserted into them:

1. the ability to target B cells using CD19 as a target

2. zap-70 to increase the signaling and activity of the T

cells

3. 4-1BB, which is a receptor to help costimulate the immune

system

These T cells, when re-infused into the patients attacked

and killed B cells. This is really the first time that we

have seen therapy such as this achieve such dramatic and

sustainable effects. Most of the prior attempts have

resulted in only small decreases over short periods of time.

The caution with this is that the patients will likely never

recover their normal B cells, and the degrees of depletion

is quite profound, as the T cells with kill both normal and

malignant B cells. IV IG will not be an adequate

replacement long term in all likelihood for these patients.

As with most novel agents, now that they have gotten the

efficacy of the therapy working, they will be able to

" tweak " it to lessen the toxicity.

Yes, this therapy is years away, and not likely to help

anyone on this list in the near future, but it does teach us

a great deal in terms of moving forward immunotherapy to

help not just CLL, but all cancer.

Rick Furman, MD

> /message/15725

[Guest guest]

I have posted 5 articles on my blog giving my take on this report:

http://mutated-unmuated.blogspot.com/2011/08/cure-for-cll-what-do-i-think.html

or http://tinyurl.com/3ohsuof

http://mutated-unmuated.blogspot.com/2011/08/more-technical-stuff-omit-if-it-isn\

t.html

or http://tinyurl.com/3pnglz3

http://mutated-unmuated.blogspot.com/2011/08/cure-for-cll-what-they-actually-did\

..html

or http://tinyurl.com/3copng6

http://mutated-unmuated.blogspot.com/2011/08/cure-for-cll-case-report.html

or http://tinyurl.com/3h3q3h8

http://mutated-unmuated.blogspot.com/2011/08/new-and-successful-treatment-cure-f\

or.html

or http://tinyurl.com/3srd8m8

Terry Hamblin

[Guest guest]

I don't understand why a patient thus treated couldn't

recover the full complement of B cell lineage. Correct me if

I'm wrong, but don't all B lymphocytes arise from

hematopoietic stem cells? If stem cells are preserved, then

why wouldn't the B lymphocyte numbers recover? T lymphocytes

don't live forever as memory B cells do. One would assume

that once these manipulated T cells die off, the B lineage

would recover.

This does not mean the treatment would work, or that

patients would survive such a 'hit' to their immune system.

Please clarify for me. Thanks.

Dr. Furman wrote:

/message/15733

[Guest guest]

CD19 is present on an earlier population than CD20, so

recovery is not guaranteed. Plus we do not know how long the

CART19 cells will persist since there are no antibodies to

eliminate them. They will eliminate fresh CD19+ B cells

while they are still active and the CD137 moiety might cause

them to proliferate indefinitely.

wrote:

I don't understand why a patient thus treated couldn't

recover the full complement of B cell lineage. Correct me

if I'm wrong, but don't all B lymphocytes arise from

hematopoietic stem cells? If stem cells are preserved, then

why wouldn't the B lymphocyte numbers recover? T

lymphocytes don't live forever as memory B cells do. One

would assume that once these manipulated T cells die off,

the B lineage would recover.

This does not mean the treatment would work, or that

patients would survive such a 'hit' to their immune system.

Please clarify for me. Thanks.