When Ava Christianson was diagnosed with cancer at the age of four, doctors said she had the best odds.
She had the most common type of leukemia, acute lymphoblastic leukemia (ALL). In 90 per cent of cases, a conventional course of chemotherapy does the trick.
But her experience was different.
By the age of eight, Wisconsin-born Ava had tried all of the standard therapies – from chemo to a bone marrow transplant – and relapsed five times.
However, since she was first diagnosed researchers have made astonishing strides in the field of immunotherapy, training patients’ bodies to fight their tumors.
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Ava Christianson (pictured) was diagnosed with cancer at the age of four. She relapsed five times despite being told she had the best odds. But now she is in remission after a clinical trial
WHAT IS CAR T-CELL THERAPY?
CAR T-Cell therapy is a kind of so-called ‘immunotherapy’.
Immunotherapy is the most promising approach to fighting cancer to date, according to the expert panel of cancer researchers that Vice President Joe Biden assembled to fight cancer.
About 30 million immune cells are taken out of the body, genetically modified using stem cells, and injected back in.
The modified cells are designed to hunt and kill the disease.
It is still being developed.
Three people died in one clinical trial this summer after the procedure caused their brains to swell.
Ava Christianson (the little girl in this story) tried one version of CAR T-Cell therapy in Minnesota last year, but it was short-lived; she relapsed.
The new trial by the National Institutes of Health has changed the target of the genetically-modified cells.
It is a groundbreaking approach that offers new hope to patients with no options left.
This year Ava became the 18th person in history to try the new five-minute operation at the National Institutes of Health’s Clinical Center.
In August, doctors gave her the all-clear.
Having been disappointed time and time again, her parents Bethany and Jay are reluctant to celebrate, but they told the Washington Post they are quietly hopeful.
‘We just need this to work and to stay working,’ Bethany said.
The new procedure – CAR T-Cell therapy – has never been tried in humans before this experiment.
CAR T-Cell therapy is where about 30 million immune cells are taken out of the body, genetically modified using stem cells, and injected back in.
The modified cells are designed to hunt and kill the disease.
Ava already tried the first version of CAR T-Cell therapy in Minnesota last year, relapsing soon after.
This year she tried a new version developed by NIH.
It is the most promising approach to fighting cancer to date, according to the expert panel of cancer researchers that Vice President Joe Biden recruited to fight cancer.
And doctors hope it could provide the key to combating leukemia, which is increasingly intelligent.
Acute lymphoblastic leukaemia (ALL) is a cancer of the white blood cells, which are made in the bone marrow.
There are two different types of white blood cells – lymphocytes and myeloid cells- and they work together to fight infection.
Normally, white blood cells develop, repair and reproduce in an orderly and controlled way.
But in leukaemia, the process gets out of control and the cells continue to divide in the bone marrow, but do not mature.
Hopeful: Despite all the setbacks, Ava’s parents Bethany (pictured) and Jay are hopeful
Ava (pictured) had the most common type of leukemia, acute lymphoblastic leukemia (ALL). In 90 per cent of cases, a conventional course of chemotherapy does the trick
These immature dividing cells fill up the bone marrow and stop it from making healthy blood cells.
As the leukemia cells fail to mature, they cannot work properly to fight infections, leading to an increased risk of infection.
Because the bone marrow cannot make enough healthy red blood cells and platelets, symptoms such as anemia and bruising can occur.
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Chronic forms of the disease tend to affect adults and are very rare in children.
Normally, children with ALL respond quickly to a bone marrow transplant.
Until recently, there was no other option.
‘Five years ago our doctor would have just had to tell us to go home,’ Bethany told the Post.
Ava already tried the first version of CAR T-Cell therapy in Minnesota last year, relapsing soon after. This year she tried a new version developed by NIH. Pictured at the NIH center
Now they are home in Prescott, Wisconsin, hoping to let Ava get on with a normal childhood.
But the number of set-backs they’ve had make it hard to believe this is it.
When it all started, their doctors said 90 per cent of children will never relapse in the rest of their lives after traditional treatment.
‘Ninety per cent, you feel pretty darn good that you’re ok,’ Bethany told the Post.
‘And then when we found out that she’d relapsed we were still told with bone marrow transplant that it was like 80-85 per cent chance that this was going to cure her.
‘So you still… you get this… “ok we just need to get through this and we’ll be ok”.
‘That’s been the most frustrating thing, you stop paying attention to the probabilities.’
Jay added: ‘It gets to a point where you’re like… “we need to figure this out” and you just keep searching and doing. Luckily we’ve been led here and hopefully this is our last stop for her and it fixes it.’
ACUTE LYMPHOBLASTIC LEUKAEMIA – A CANCER COMMON IN CHILDREN AGED ONE TO FOUR YEARS OLD
Acute lymphoblastic leukaemia (ALL) is a cancer of the white blood cells.
All white blood cells are made in the bone marrow.
There are two different types of white blood cells – lymphocytes and myeloid cells.
They work together to fight infection.
Normally, white blood cells develop, repair and reproduce in an orderly and controlled way.
But in leukaemia, the process gets out of control and the cells continue to divide in the bone marrow, but do not mature.
These immature dividing cells fill up the bone marrow and stop it from making healthy blood cells.
Acute lymphoblastic leukaemia (ALL) is a cancer of the white blood cells. Normally, white blood cells develop, repair and reproduce in an orderly and controlled way. But in leukaemia, the process gets out of control and the cells continue to divide in the bone marrow, but do not mature. These immature dividing cells fill up the bone marrow and stop it from making healthy blood cells
As the leukaemia cells fail to mature, they cannot work properly to fight infections.
This leads to an increased risk of infection, and because the bone marrow cannot make enough healthy red blood cells and platelets, symptoms such as anaemia and bruising can occur.
There are four main types of leukaemia:
- acute lymphoblastic
- acute myeloid
- chronic lymphocytic
- chronic myeloid
Chronic forms of the disease tend to affect adults and are very rare in children.
Acute lymphoblastic leukaemia is specifically a cancer of the immature lymphocytes, called lymphoblasts or blast cells.
The causes of ALL are not yet known but studies have found identical twins and brothers and sister are at an increased risk of the disease.
Symptoms of ALL are similar to other forms of leukaemia, and include:
- a child becoming lethargic and tired due to anaemia, caused by a lack of red blood cells
- bruising
- bleeding taking longer to stop, due to low levels of platelets, which help blood clot
- some children suffer infections because of low levels of white blood cells
- a child is likely to feel generally unwell
- suffer aches and pains
- swollen lymph glands
Source: Macmillan Cancer Support