Life Extension Magazine®
Researcher using microscope to study immuno-therapy for study

Case Study: Fighting Leukemia

Immunotherapy combined with conventional chemo resulted in complete remission in a patient with chronic lymphocytic leukemia.

Scientifically reviewed by: Dr Gary Gonzalez, MD, on July 2021. Written By Charles Bolton.

Portrait of Dipnarine Maharaj, MD

The patient was running out of options.

She was suffering from a more aggressive type of chronic lymphocytic leukemia (unmutated IGHV gene).1

Conventional chemotherapy had been unsuccessful. Her prognosis was grim.

Clinician scientists with the Maharaj Institute of Immune Regenerative Medicine in Florida turned to one of the most promising new treatments in the war against cancer: immunotherapy.

By treating her with an immune system stimulant combined with personalized, targeted cancer therapy, these clinicians were able to halt the patient’s cancer in its tracks.1

The ability to achieve complete remission with zero evidence of cancer remaining in the blood may represent a new treatment model for chronic lymphocytic leukemia and many other cancers.

A Common Killer

Woman sitting in hospital gown due to leukemia

Leukemias are a group of related cancers that affect the cells of the blood or bone marrow.

Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults.1 Unlike acute leukemias, it does not progress rapidly–though for many it can still be fatal.2

In 2021, the American Cancer Society estimates that 21,250 new cases of CLL will be diagnosed, and around 4,320 patients will die from it.3

There are different kinds of chronic lymphocytic leukemia. The unmutated IGHV type is a more aggressive form. Even with treatment, patients typically have only one to five years of progression-free survival.4

One of the worst consequences of CLL is that it devastates the immune system.

Using Immunotherapy to Fight Leukemia

  • Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults. It has very low rates of remission or cure.
  • This cancer causes defects in the patient’s immune system, helping it evade detection and destruction by immune cells.
  • Immunotherapy is a treatment that boosts a person’s own immune system, helping it to target and attack cancer cells.
  • Clinician scientists at the Maharaj Institute of Immune Regenerative Medicine in Florida successfully used immunotherapy in a female patient with CLL after conventional treatment failed.
  • They used a synthetic form of interleukin-2 (IL-2), a signaling protein that regulates immune function, to stimulate the immune system to destroy the cancer.
  • They also used a cancer drug, venetoclax, at low doses to avoid side effects.
  • The combination appeared to boost the effectiveness of treatment, sending the patient’s cancer into complete remission.

For example, natural killer (NK) cells are a vital part of the body’s defense against cancer. NK cells attack cancer cells directly and help to improve function of other immune cells. When working optimally, NK cells are able to control the spread of tumors.5,6

In chronic lymphocytic leukemia, the cancer weakens the immune system. This causes the loss of NK cell function.7,8 As a result, NK cells are unable to exert their usual powerful anti-cancer activities.

New Hope from Immunotherapy

Immunotherapy has been at the forefront of recent advances in cancer treatment.

This therapy boosts the body’s own immune system, improving its natural ability to find and destroy cancer cells.

Immunotherapy treatments are constantly being tested and approved. Physicians at the Maharaj Institute of Immune Regenerative Medicine, located in Boynton Beach, Fla., turned to one to treat a leukemia patient who had failed to respond to other therapies.1

A Novel Approach to CLL

Couple speaking with doctor on immuno-therapy option

The patient was a 56-year-old woman with unmutated IGHV CLL—a more aggressive type.

She was initially treated with a standard drug that targets leukemia. After suffering a severe adverse reaction, she had to terminate treatment.

The cancer appeared to go into remission. But about a year after stopping treatment, it was back.

The clinicians at the Maharaj Institute decided to use immunotherapy to stimulate the immune system to better fight against the cancer.

They opted to use a synthetic form of interleukin-2 (IL-2).

IL-2 is a signaling protein produced in the body which regulates aspects of immune function. It is essential for the growth and activation of various immune cells, including natural killer cells.9

Once activated by IL-2, NK cell function gets a boost. These immune cells are more easily able to recognize threats, dramatically improving their ability to kill tumors and other abnormal cells.9-11

How the Treatment Worked

The patient was started on the interleukin-2 combined with the cancer drug lenalidomide—at a much lower dose than usual, to minimize side effects.

After several cycles of this therapy, the number of cancer cells in the patient’s blood decreased. But the cancer did not go into complete remission.

After some time, the physicians decided to try a different cancer drug along with the IL-2 treatment. Several cycles of IL-2 and low-dose venetoclax were initiated.

Although venetoclax can be associated with severe side effects at standard doses, at low doses it is well tolerated. The patient did not have any significant negative effects during this treatment.

Prior studies have suggested that even at low doses, venetoclax can induce the death of CLL cancer cells.12,13 In this case, the IL-2 appeared to boost the effectiveness of the treatment, stimulating the patient’s immune system to fight the cancer while also killing cancer cells.

The number of cancer cells in the blood dropped dramatically with this new therapy. Six months after treatment began, tests could find no evidence of cancer in the blood. The patient was in complete remission.

The therapy was discontinued, but follow-up testing three months and nine months later showed that the patient was still in remission, with zero evidence of cancer detected.

Adding a low-dose cancer drug like venetoclax appears to create a potent combination that kills cancer cells and repairs the immune system defects caused by the cancer.

Summary

Current treatments for chronic lymphocytic leukemia, the most common form of leukemia in adults, do not cure the disease and can cause serious side effects.

Cancer experts at the Maharaj Institute of Immune Regenerative Medicine used a novel approach that aims to improve the effectiveness of treatment while reducing the risk of serious side effects.

A woman with an aggressive form of CLL was treated with a combination of immunotherapy (with a form of the immune-stimulating protein IL-2) and a low dose of the cancer drug venetoclax.

The result was complete remission of the cancer with no signs of recurrence nine months after stopping treatment.

This preliminary report gives hope that this new treatment protocol can greatly improve the care of patients with chronic lymphocytic leukemia as well as other cancers.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

Important Notice

Lab worker holding vial of blood of leukemia patient

Since LifeExtension® began publishing in 1980, we’ve reported on novel therapies to treat lethal diseases, many that eventually obtain approval in the United States and/or other countries.

A significant obstacle in patients gaining access to these therapies is that until the therapies receive FDA approval for the patient’s specific indications, private insurance and Medicare typically do not pay for them.

We sometimes have readers who are angry that a novel treatment protocol we write about is not affordable to them because their insurance will not cover it.

While we greatly regret this, our hands are tied.

On the upside, our publication enlightens patients about potentially more effective therapies, and these people often report back to us about the success or failure of such treatments.

References

  1. Maharaj D, Srinivasan G, Abreu MM, et al. Molecular Remission Using Low-Dose Immunotherapy with Minimal Toxicities for Poor Prognosis IGHV-Unmutated Chronic Lymphocytic Leukemia. Cells. 2020 Dec 22;10(1).
  2. Available at: https://www.ashclinicalnews.org/spotlight/chronic-lymphocytic-leukemia-curable/. Accessed July 1, 2021.
  3. Available at: https://www.cancer.org/cancer/chronic-lymphocytic-leukemia/about/key-statistics.html. Accessed June 30, 2021.
  4. Crombie J, Davids MS. IGHVmutational status testing in chronic lymphocytic leukemia. American Journal of Hematology. 2017;92(12):1393-7.
  5. Jewett A, Kos J, Kaur K, et al. Natural Killer Cells: Diverse Functions in Tumor Immunity and Defects in Pre-neoplastic and Neoplastic Stages of Tumorigenesis. Mol Ther Oncolytics. 2020 Mar 27;16:41-52.
  6. Vivier E, Tomasello E, Baratin M, et al. Functions of natural killer cells. Nat Immunol. 2008 May;9(5):503-10.
  7. MacFarlane AW, Jillab M, Smith MR, et al. NK cell dysfunction in chronic lymphocytic leukemia is associated with loss of the mature cells expressing inhibitory killer cell Ig-like receptors. OncoImmunology. 2017 2017/07/03;6(7):e1330235.
  8. Parry HM, Stevens T, Oldreive C, et al. NK cell function is markedly impaired in patients with chronic lymphocytic leukaemia but is preserved in patients with small lymphocytic lymphoma. Oncotarget. 2016;7(42):68513-26.
  9. Yu T-K, Caudell EG, Smid C, et al. IL-2 Activation of NK Cells: Involvement of MKK1/2/ERK But Not p38 Kinase Pathway. The Journal of Immunology. 2000;164(12):6244-51.
  10. Fehniger TA, Bluman EM, Porter MM, et al. Potential mechanisms of human natural killer cell expansion in vivo during low-dose IL-2 therapy. The Journal of clinical investigation. 2000;106(1):117-24.
  11. Maharaj D, Vianna P, DeCarvalho G, et al. Molecular remission using low-dose immunotherapy for relapsed refractory Philadelphia chromosome-positive precursor B-cell acute lymphoblastic leukemia post-allogeneic stem cell transplant. Future science OA. 2019;5(5):FSO380.
  12. Anderson MA, Deng J, Seymour JF, et al. The BCL2 selective inhibitor venetoclax induces rapid onset apoptosis of CLL cells in patients via a TP53-independent mechanism. Blood, The Journal of the American Society of Hematology. 2016;127(25):3215-24.
  13. Seymour JF, Davids MS, Roberts AW, et al. Safety profile of venetoclax monotherapy in patients with chronic lymphocytic leukemia. Blood. 2016;128(22):4395.