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Promising Cell Therapy Offers Hope for Relapsed or Refractory T-Cell Leukaemia
Singapore, October 5, 2024 : A groundbreaking cell therapy targeting CD7 on leukaemia cells shows promise as a treatment for patients with relapsed or refractory T-cell acute lymphoblastic leukaemia (T-ALL) who have exhausted standard treatment options. The study, published in the esteemed medical journal Nature Medicine on September 3, 2024, emphasizes the efficacy of a novel chimeric antigen receptor (CAR) T-cell therapy.
This therapy was developed by researchers and clinicians from the Yong Loo Lin School of Medicine at the National University of Singapore (NUS Medicine) and the National University Health System (NUHS). It was administered to 17 patients from April 2019 to October 2023 at the National University Hospital (NUH) in Singapore and Ospedale Pediatrico Bambino Gesu in Rome, Italy.
All patients, aged between two and 72, had T-ALL that could not be eradicated by chemotherapy or had relapsed post-treatment. The approach involved reprogramming the patients' own T cells to express an anti-CD7 CAR, which were then reinfused into their bodies. This anti-CD7 CAR protein directs the CAR T-cells to attack T-leukaemia cells expressing CD7 on their surface.
Remarkably, 16 out of the 17 patients achieved complete remission within one month, with leukaemic cells becoming undetectable even using ultra-sensitive flow cytometry tests capable of identifying one leukaemia cell amid 10,000 normal cells. These advanced techniques were essential for analyzing CD7 expression in leukaemic cells, determining patient eligibility, and monitoring CAR-T cell expansion and persistence post-infusion. The first patient treated with this therapy has remained in remission for five years without requiring additional chemotherapy or a bone marrow transplant.
The treatment was generally well-tolerated, with only mild side effects, despite all participants having a high tumour burden and undergoing extensive prior treatment.
T-ALL comprises around 10% of ALL cases in children and 25 to 30% in adolescents and young adults. While 70 to 80% of children can be cured with intensive chemotherapy, the cure rate for adults hovers around 60% or lower. For patients with relapsed or refractory T-ALL, the survival rate is below 10%, whereas this study reported a 50% survival rate among its participants. This fratricide-resistant CD7 CAR-T therapy is currently being tested at NUH.
Dr. Bernice Oh, the study's first author and a Consultant in the Division of Paediatric Haematology and Oncology at the Khoo Teck Puat - National University Children's Medical Institute (KTP-NUCMI), NUH, expressed optimism: "This CAR-T therapy offers a new and promising option for T-ALL patients who have failed conventional treatments. We are encouraged to provide them with another viable chance at a cure without severe side effects. We are dedicated to seeking improved cures for patients with complex and treatment-resistant cancers."
Professor Allen Yeoh, who spearheaded the clinical application of this technology and is the Head and Senior Consultant in the Division of Paediatric Haematology and Oncology at NUH's KTP-NUCMI and the National University Cancer Institute, Singapore, added: "While we celebrate this significant milestone, we recognize we are at the beginning of an exciting journey. There remains much to learn from each patient in this study. Ultimately, witnessing each patient's smile and granting them another opportunity after achieving remission is priceless." Professor Yeoh is also the VIVA-Goh Foundation Professor in Paediatric Oncology at NUS Medicine.
This research is supported by the Singapore Ministry of Health through the National Medical Research Council (NMRC) Office, along with several other organizations and grants.
About the National University Health System (NUHS)
The National University Health System (NUHS) strives to transform illness prevention and management by uncovering disease causes, developing effective treatments through collaborative research and clinical trials, and creating enhanced care delivery systems in partnership with like-minded entities.
NUHS comprises institutions including the National University Hospital, Ng Teng Fong General Hospital, Jurong Community Hospital, and Alexandra Hospital, as well as three National Specialty Centres. It integrates patient care, health science education, and biomedical research under a unified governance structure.
About the National University Hospital (NUH)
The National University Hospital (NUH) is Singapore's leading university hospital, providing a comprehensive range of medical, surgical, and dental specialties. As a key member of the National University Health System, NUH serves over one million patients annually.
About the National University Cancer Institute, Singapore
The National University Cancer Institute, Singapore (NCIS) offers a full spectrum of cancer care, including screening, diagnosis, treatment, rehabilitation, and palliative care. It emphasizes a multidisciplinary approach to provide personalized plans for each cancer patient.
About the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine)
NUS Medicine is Singapore's first and largest medical school, committed to nurturing healthcare professionals and advancing health through innovative research. It ranks among the leading medical schools in Asia and globally.
About the National Medical Research Council (NMRC)
Established in 1994, the NMRC oversees research funding from the Ministry of Health, supporting biomedical research development and the advancement of clinician scientists through various awards and fellowships.
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