What if Cancer got AIDS?

At first, this question might seem ridiculous. But that’s exactly what happened to a 7-year-old Pennsylvania girl named Emma. Well, sort of.

When she was just 5 years old, Emma was diagnosed with acute lymphoblastic leukemia. After being treated with chemotherapy for over a year, her cancer relapsed and she took a turn for the worse. When it looked like Emma had run out of options, her parents signed her up for an experimental treatment in which she would be given genetically modified HIV to help her fight her cancer.

The Human Immunodeficiency Virus (HIV), as you’re probably aware, is the virus that causes AIDS. When a person is infected with HIV, the virus attacks a type of white blood cell known as T-cells. T-cells are important in cell-mediated immunity, which means they can either directly attack invading cells or send chemical signals called cytokines to other immune cells to help fight an infection. A T-cell infected with HIV loses its normal function. This typically causes people who are infected with HIV to become immunocompromised. But in Emma’s case the ability for HIV to alter T-cell function would be used to help to fight her disease.

Because of her leukemia, Emma’s other white blood cells known as B-cells had become malignant. Normally, these B-cells can fight off infections by recognizing foreign substances called antigens. In the presence of an antigen, healthy B-cells create antibodies. These antibodies bind to the antigen and tell the body to start an immune response.

Since, HIV naturally changes T-cells, doctors thought they could use it to reprogram the T-cells to attack the cancer cells in Emma’s body. Using a modified HIV virus that wouldn’t cause AIDS, doctors successfully transformed Emma’s T-cells.

When doctors gave this treatment to Emma, a her body mounted a huge immune response as her reprogrammed T-cells began to attack her cancerous B-cells. But there was a complication. The massive immune response caused a high fever, dangerously low blood pressure and in a coma. As it looked like Emma might not survive this experimental procedure, doctors discovered from her blood work that this reaction was due to a massive increase in an inflammatory cytokine known as interleukin-6. Once they were able to isolate the cause of Emma’s symptoms, they were able to help her. They treated Emma with an immunosuppressive drug called tocilizumab, which is normally used to treat rheumatoid arthritis.

It worked. Though Emma had a close call, she woke up one week later. She went on to make a full recovery, and now her leukemia is in remission. Emma’s story shows what kinds of breakthroughs may be possible as we continue to learn more about HIV and AIDS and keep searching for a cure.

Article by Tom Batemarco, Volunteer Contributor.

Author: Michael Morgenstern M.D.

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