Immunotherapy

Leukemia

Leukemia starts in the blood and bone marrow and occurs when white blood cells, leukocyctes, in the body mutate (change) and grow uncontrollably. Chemotherapy, targeted therapy, immunotherapy and stem cell transplantation, used alone or in combination, are treatment options for leukemia. Following are some of the most common forms of leukemia treated with immunotherapy. Additional strategies for these and other types of leukemia are being researched in clinical trials.

Acute Lymphocytic Leukemia

Acute lymphocytic leukemia (ALL), also referred to as acute lymphoblastic leukemia, is a fast-growing cancer of the blood and bone marrow. It starts in the cells that become lymphocytes, a type of white blood cell. To treat ALL, different treatments or a combination of treatments may be given in three phases of treatment: induction, consolidation and maintenance.

In 2014, the U.S. Food and Drug Administration (FDA) approved the first immunotherapy strategy to treat ALL, indicated specifically for the treatment of Philadelphia chromosome-negative relapsed (cancer that has come back after treatment) or refractory (cancer that is not responding to treatment) B-cell precursor ALL. Since then, the FDA has expanded the drug’s use to include Philadelphia chromosome-positive relapsed and refractory B-cell precursor ALL.

In 2017, the FDA approved the first gene therapy in the United States. This breakthrough drug is known as a chimeric antigen receptor (CAR) T-cell therapy and is approved to treat certain children and young adults with B-cell ALL. CAR T-cell therapy is the use of a patient’s own immune cells, or T-cells, that are re-designed to recognize and kill ALL cells.

Additional immunotherapy strategies are being studied in clinical trials (see Clinical Trials). Ask your doctor if you are a candidate for a clinical trial.

Chronic Myeloid Leukemia

Chronic myeloid leukemia (CML) is a cancer of the bone marrow and blood. It is a slow-growing leukemia that develops when a genetic change mutates or damages immature myeloid cells, which are the cells that become white blood cells (other than lymphocytes), red blood cells or cells that make platelets.

The type of immunotherapy used to treat CML is called an interferon, which is a cytokine. Cytokines are proteins made naturally in the body or made in a laboratory, and they act primarily by helping the various cells of the body’s immune system communicate. They are capable of stimulating the immune system or slowing it down in order to help it fight cancer. Interferons can reduce the number of white blood cells and the number of cells that contain the Philadelphia chromosome.

Researchers conducting clinical trials are exploring how to prevent, diagnose and treat CML. Cancer treatment vaccines may be used to stimulate the immune system to recognize cancer cells as a threat to the body, and to destroy them. Currently, clinical trials are assessing how this type of treatment may be used against the Philadelphia chromosome in patients with CML. Talk with your doctor about clinical trials, and whether one may be right for you (see Clinical Trials).

Hairy Cell Leukemia

Hairy cell leukemia is a rare type of cancer of the blood and bone marrow, which is the soft tissue in the center of most bones. It gets its name from the “hairy” appearance its cells have when viewed under a microscope. In hairy cell leukemia, too many blood stem cells become lymphocytes, which are white blood cells that help fight infections. However, these lymphocytes are abnormal and do not become healthy white blood cells. They become leukemia cells that can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells and platelets.

One type of immunotherapy approved for hairy cell leukemia is a cytokine. Cytokines are proteins made naturally in the body or made in a laboratory, and act primarily by helping the various cells of the body’s immune system communicate. They are capable of stimulating the immune system or slowing it down in order to help it fight cancer. Typically, the cytokines used for hairy cell leukemia are interferons.

Alpha interferon was approved in 1986 and represented a new and exciting advance in the treatment of hairy cell leukemia. Until that time, splenectomy (the removal of the spleen) was the only known effective therapy for this disease. Interferon benefited people with active hairy cell leukemia, regardless of whether they had a splenectomy. At this time, interferon has a relatively limited role in the treatment of hairy cell leukemia, so discuss with your doctor if it is appropriate for you.

Other types of treatment are being tested in clinical trials (see Clinical Trials). Talk to your doctor about all of your treatment options, and ask if a clinical trial may be an option for you.

 

FDA-Approved Immunotherapies for Leukemia*
As of 12/5/17
Acute Lymphocytic Leukemia
blinatumomab (Blincyto)
Acute Precursor B-cell (Pre-B-cell) Lymphoblastic Leukemia
blinatumomab (Blincyto)
tisagenlecleucel (Kymriah)
Acute T-cell (Lymphoblastic) Leukemia
interferon alfa
B-cell Chronic Lymphocytic Leukemia
alemtuzumab (Campath)
rituximab (Rituxan)
Chronic Myeloid Leukemia
interferon alfa
Hairy Cell Leukemia
interferon alfa-2b (Intron-A)
rituximab (Rituxan)
Prolymphocytic Leukemia
alemtuzumab (Campath)

*Each therapy is prescribed based on specific criteria. Discuss your options with your doctor.

Additional Resources

Acute Lymphocytic Leukemia

Chronic Myeloid Leukemia

Hairy Cell Leukemia

 

Previous Next


Register Now! Sign Up For Our Free E-Newletter!

Read Inspiring Cancer Survivor Stories

Order Your Guides Here