Inside Pediatrics Winter 2018

In 2018, Hayden was faced with very few options to continue fighting his cancer. Kutny and his team recommended he try an FDA-approved immunotherapy called chimeric antigen receptor (CAR) T-cell therapy. Children’s is one of about 35 healthcare institutions in the U.S. and the only pediatric provider in Alabama chosen to offer the treatment intended for children and young adults with ALL. “CAR T-cell therapy is truly a breakthrough therapy in cancer treatment,” Kutny said. “The CAR T-cell therapy takes a patient’s own immune cells, white blood cells that normally fight infection, and programs the cells to recognize and destroy the patient’s leukemia cells.” The U.S. Food and Drug Administration requires all treatment sites providing CAR T-cell therapy have certification and training to handle potential risks and complications involved with this type of treatment such as high fevers, low blood pressure and difficulty breathing that may require a stay in the intensive care unit. Investigators at Children’s and UAB are working to create a new strategy in CAR T-cells that can better control this immune response or shut it off once it is no longer needed. “We are excited about this therapy approach because it generally results in less toxicity and side effects compared to

other chemotherapy used to treat leukemia and lymphoma,” Kutny said. “Hayden and his father have always been troupers through his journey, and they have kept a positive attitude. Hayden is really into wrestling and that really encapsulates Hayden’s approach to taking on his cancer. He is always ready for the next fight to take it on.” Kutny says Hayden has responded very well to the CAR T-cell therapy so far. “We are watching closely how he responds to the treatment, and are hopeful this will be a cure for him,” Kutny said. Children’s is also studying a range of antibody immunotherapies. These therapies can activate the patient’s immune system to attack the cancer or the antibodies can be linked to chemotherapy medicines in order to more precisely deliver the medicine to the cancer cells. “This can result in fewer side effects compared to our traditional systemic chemotherapies,” Kutny said. “We have used these antibody therapies with great success in patients with relapsed leukemia and lymphoma. Now we are studying how to replace traditional chemotherapy with these immunotherapies in order to decrease the side effects of cancer treatment and further improve cure rates.”

Twelve-year-old Hayden Parker and his father, Bryan Qualls, check in with pediatric hematologist/oncologist Matthew Kutny, M.D., at Children’s of Alabama in August 2018. Hayden, diagnosed with acute lymphoblastic leukemia, is currently undergoing chimeric antigen receptor T-cell therapy, “truly a breakthrough therapy in cancer treatment,” Kutny says.

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