Non-Hodgkin Lymphoma Patient Is 3rd in the World to Receive CAR T-Cell Therapy

In August 2013, active, stay-at-home mom Emily Dumler was surprised to discover blood in her stool. She took the finding seriously, wanting to remain healthy to focus on the needs of her young daughters and son. She headed to a nearby outpatient urgent care center.

“I was alarmed, but expected a 1-hour appointment and medication to solve the problem,” she says. “Instead, I was admitted to the hospital, where I stayed for 43 days.”

Emily, then 32, had non-Hodgkin lymphoma. She immediately began treatment at The University of Kansas Cancer Center. She received chemotherapy and a stem cell transplant, but neither treatment eradicated the cancer.

“I was told that my only chance at a cure was CAR T-cell immunotherapy,” Emily says. “It was so new, it wasn’t yet available here in Kansas. My doctors started calling around. They found a clinical trial at another cancer center that had one spot left. I was able to enroll in that last spot, and I became the 3rd person in the world to receive CAR T-cell treatment.”

CAR T-cell therapy: The future is now

Breakthrough CAR T-cell precision cancer therapy represents the future of cancer treatment.

“Immunotherapy is a very promising area in medicine,” explains Joseph McGuirk, DO, division director of hematologic malignancies and cellular therapeutics for The University of Kansas Cancer Center. “It leverages our increased understanding of how the immune system works so that we can manipulate that immune system to improve outcomes for patients with medical illness. CAR T cells are extraordinarily exciting. Patients’ T cells are taken out, re-engineered in a laboratory to do the work they failed to do in the first place, and expanded and infused back into the patient. We are seeing some truly stunning results in several diseases.”

Today, some CAR T-cell therapies have become FDA-approved to treat certain types of cancers. But at the time that Emily needed the therapy to save her life, its effects were unknown. Her apheresis – the process by which her own cells were collected – went smoothly, but on infusion day, “There were tons of people all crowded into my hospital room,” she says, all at the ready to learn from the experience and support her through the groundbreaking treatment.

“I was such an early patient, we just didn’t know what would happen,” Emily says. “But I had been well-prepared with an awareness of the sorts of reactions and side effects that could occur.”

And many side effects that could occur, did occur. During her infusion, a sinus problem intensified, and her IV was temporarily stopped so she could receive an antihistamine. Later, she experienced flu-like symptoms followed by neurological toxicity.

“They watched for that very, very closely,” she says. “They did cognitive exams several times a day, asking questions that seemed so silly – like did I know my name, and could I name a shape – until I couldn’t answer them. I ended up losing my cognitive function and my memory for about 24 to 36 hours. Fortunately, medications reversed all those side effects in time.”

A new perspective

Today, Emily is healthy and strong. She has returned to employment outside the home, serving as the director of religious education for her church, and enjoys attending her children’s many sporting events with her husband. She still visits her care team once or twice a year, but believes the cancer is gone. Her experience has brought a significant new perspective.

“I always had this thought or feeling that a clinical trial wouldn’t be a good thing,” she says, “but when I personally was faced with that need, I felt completely differently. That trial was my chance at life. It was my hope. I didn’t know if it would work, but I felt nothing but excitement for having that chance.”

And despite the challenges and the low points she and her family experienced, Emily wouldn’t change her journey.

“It may be easier for me to say because of where I’m sitting today, but I would never take back having had cancer,” she says. “I am a different person for it, and for the better. I learned so much about myself and what is truly important in life. And I signed up for the trial for myself, to save my own life, but there is so much that is coming from these efforts, so much for the cancer community to gain. It is amazing to be some part of that, and I feel truly blessed.”