Attipoe 1

Senam Attipoe

Ms. Curtin

Independent Research G/T

30 April 2018

CAR T or Transplants?

Every three minutes, someone in the United States is diagnosed with a blood cancer

(Leukemia Lymphoma Society 2015). The most common blood cancer is leukemia which is the

most common type of cancer among children and the deadliest among seniors. Conventional

treatments such as radiation therapy, chemotherapy, and surgery are typically the first treatments

to be used on a patient, but they yield less than a 70% success rate (Survival Rates). Such

statistics reveal quite boldly that scientists should be researching and utilizing alternative,

nonconventional treatments. Stem cell transplantations and immunotherapy, otherwise referred

to as chimeric antigen receptor therapy, are two fairly new and nonconventional leukemia

treatments that prove to be very successful. Immunotherapy is the best nonconventional

leukemia treatment because of its high and long-lasting remission rates; it should be incorporated

into regular hospital treatment regimens.

Leukemia is a potentially fatal cancer of the blood. In 2017, 172,910 people were

diagnosed (LLS 2017). There are three treatments that are often a doctor’s first inceptive

treatment options. Conventional treatments like radiation therapy and mastectomy surgeries,

despite being the most common, only yield an average success rate of less than 70% (Survival

Rates). There are newer, more successful treatments such as immunotherapy and stem cell

transplantations. Immunotherapy essentially trains the immune system to recognize cancer cells

as dangerous, and therefore equips the body with a new defense system that is trained to fight off
 Attipoe 2

cancer cells (Regalado 1-10). Stem cell transplantations replace damaged cells with healthy stem

cells, typically from bone marrow (Stenson).

Immunotherapy and stem cell transplants are two of the most impressive leukemia

treatments, but one is significantly more impressive than the other: immunotherapy.

Immunotherapy yields higher and longer lasting remission rates than stem cell transplants

(Keown). The remission rate of immunotherapy, based on the most successful clinical trials, is

93% whereas the remission rate of stem cell transplantations is only 62% (National Cancer). The

reason the effects of remission last so long is because with immunotherapy, the patient’s immune

system becomes better equipped to battle leukemia. When the patient’s T cells are removed, they

are reengineered and then reentered into the patient’s body through his or her veins (Regalado).

These reengineered cells help the immune system to recognize cancer cells as dangerous.

Immunotherapy works like a medicine that is never fully eliminated from the

bloodstream; the immune system continues to fight off newly recognized dangerous cells for

weeks, months, and years after initial treatment (Engber 2017). Stem cell transplantations, on the

other hand, do not train the body to fight of cancerous cells. The transplants are more of an

immediate treatment that only focus on the cancer cells that are currently in the body, rather than

conditioning the body to fight cancer cells now and in the future like immunotherapy. Because of

this, with stem cell transplantations, there is always a possibility that the patient could relapse if

remission was ever achieved.

Immunotherapy also works faster than stem cell transplantations. Immunotherapy

produces quick, significant results, while the results of stem cell transplants take longer to be

seen. Studies show that the effects of immunotherapy are seen incredibly quickly- in about a

month or less, which is quicker than those of stem cell transplants. In one study, two out of three
 Attipoe 3

immunotherapy patients achieved remission after just four weeks (Greenwood). The third

patient, after approaching the same benchmark, did not achieve remission, but saw incredibly

significant results. Stem cell transplant results are not seen as early as immunotherapy results-

transplantation results are not seen for six to seven weeks (Greenwood). While six to seven

weeks is not a tremendously long amount of time, it is longer than the amount of time it takes for

immunotherapy results to surface. After the results surface, how these two treatments adversely

effect the body differs.

Immunotherapy bears less severe side effects than stem cell transplants. Adverse effects

of immunotherapy include nausea, fatigue, weakness, fever, chills and vomiting (ASCO

Cancer.net). Adverse effects of stem cell transplantations include acquiring a life-threatening

infection or complications (Thomson Gale 2006). After a successful transplant, a patient must be

closely monitored for months for transplant-related diseases and conditions (Leukemia and

Lymphoma). One of the most common post-procedure diseases is Graft vs. Host Disease

(GVHD), in which a patient’s new stem cells attack the body. The healthy tissues and organs are

attacked by the new cells which could impair function or cause total failure (Leukemia and

Lymphoma).

Because of the higher and longer lasting remission rates, the quicker and more significant

results, and the less severe side effects, immunotherapy is the better non-conventional leukemia

treatment. Immunotherapy should be incorporated into regular hospital treatment regimens.

Because the remission rate is so high, doctors should consider this as one of the first options for

patients diagnosed with leukemia, rather than a last-resort option.

 Attipoe 4

Bibliography

ASCO Cancer.net ASCO, 2005, www.cancer.net/navigating-cancer-care/how-cancer-

treated/immunotherapy-and-vaccines/side-effects-imunotherapy.
Accessed 15 Mar. 2018

ENGBER, DANIEL. “Body, Heal Thyself.” Popular Science, vol. 289, no. 6, Nov/Dec2017, p.
16. EBSCOhost.
Search.ebsco.com/login.aspx?direct=true&db=sch&AN=125580362&site=ehost-live.

Greenwood, Veronique. “Immune Supercells Purge Leukemia.” Discover Magazine,

2012. Accessed 4 Apr. 2018

Keown, Susan. “93 percent of advanced leukemia patients in remission after immunotherapy.”
Fred Hutch, 25 Apr. 2016, www.fredhutch.org/en/news/center-news/2016/04/advanced-
leukemia-remission-immunotherapy.html.

Leukemia and Lymphoma Society. www.lls.org/http%3A/llsorg.prod.acquia-sites.com/

Facts-and-statistics/facts-and-statistics-overview/facts-and-statistics.
Accessed 15 Mar. 2018

“MSK’s One-Year Survival Rate after Allogeneic Bone Marrow Transplant.” Memorial Sloan
Kettering, 26 Mar. 2012, www.mskcc.org/blog/msk-s-one-year-survival-rate-after-allogeneic-
bone-marrow-transplant-exceeds-expectations.

My Science Shop. www.myscienceshop.com/product/back- issue/dsc120201. Accessed 15 Mar.

2018.

National Cancer Institute. National Institutes of Health, 7 Jan, 2015,

www.cancer.gov/about-cancer/treatment/cam/patient/cancell-pdq. Accessed 15
Mar. 2018

Regalado, Antonio. “Biotech’s Coming Cure.” MIT Technology Review.

“Stem Cell Transplantation.” Gale Encyclopedia of Medicine, 3rd ed. Encylclopedia.com. 15

Mar. 2018 <http://www.encyclopedia.com>.

Stenson, Jacqueline. “To Bank or Not to Bank.” Ebscohost, Aug. 2012,

EBSCOhost.Search.ebscohost.com/
Login.aspx?direct=true&db=f5&AN=78002792&site=ehost-live.

“Survival Rates for Childhood Leukemias.” American Cancer Society,

www.cancer.org/cancer/leukemia-in-children-/detection-diagnosis-staging/
survival-rates.html. Accessed 9 Apr. 2018