Back to an Active Life After CAR T-Cell Therapy for Leukemia
Kim Callemyn smiles on a bridge at the Hillsborough Riverwalk, a trail she often bikes with her husband.
Kim Callemyn was always full of energy, so in January 2022 when she found herself too tired to perform basic tasks, she knew something was wrong. After two trips to the ER, she learned that she had an aggressive form of leukemia. Two rounds of chemotherapy did little to slow progression of the disease. Yet, two months after undergoing a new cancer treatment called CAR T-cell therapy at Duke, Callemyn was declared cancer-free. Today she’s back to her active life and enjoying every minute of it.
A Frightening Diagnosis
In November 2021, 59-year-old Callemyn and her husband traveled from their home in Hillsborough, NC to Florida, to work on their boat and enjoy the warm weather. Two months into their visit, she noticed blood in her stools, and then she began passing blood clots. Callemyn became so weak she could barely walk. Her husband took her to the emergency room in Fort Pierce, FL, where she received a blood transfusion and underwent countless medical tests -- but doctors could not identify the cause of her illness. She felt better when she left the hospital, but the blood clots and weakness returned a week later. Callemyn was diagnosed with B-cell acute lymphoblastic leukemia and sent to a specialty hospital in Orlando where she spent two months receiving chemotherapy.
CAR T-Cell Therapy for B-Cell Acute Lymphoblastic Leukemia
Once she was released, Callemyn and her husband headed back to North Carolina to meet with Duke hematologic oncologist Carlos M. De Castro III, MD. Under his care, Callemyn underwent a second round of chemotherapy. When her body did not respond as he hoped, Ahmed Galal, MD, a cellular therapist and hematologic oncologist at Duke Health, evaluated Callemyn to see if she was a candidate for CAR T-cell therapy.
Enhanced T-Cells Recognize and Attack Cancer Cells
In CAR T-cell therapy, T-cells -- a special type of white blood cells -- would be extracted from Callemyn’s body, sent to an off-site lab, and genetically engineered to target her specific type of cancer. Then the re-engineered cells would be infused back into her body. The hope was that the enhanced T-cells would better identify and attack her cancer cells. Just weeks before, a drug often used in CAR T-cell therapy (called Tecartus®) was approved by the FDA to treat Callemyn’s type of leukemia.
Dr. Galal determined that Callemyn was a candidate for CAR T-cell therapy, but she had to get healthier before undergoing the treatment. “Her disease was quite progressive, so we treated her with an immune therapy medication first to get it under control,” Dr. Galal explained. Once that goal was accomplished, she underwent CAR T-cell therapy.
Because of potential side effects -- like neurotoxicity, which causes confusion and dizziness -- most CAR T-cell therapy patients are infused in the hospital. Callemyn experienced these side effects, “but the nurses at Duke were my saviors,” recalled Callemyn. “They were all fantastic and got me through.”
Impressive Results and a Promising Future
Six weeks after her CAR T-cell therapy, there was no trace of leukemia in Callemyn’s body. “She bounced back after about two months, and right away she got back to her projects and her work as if she never had any issue. That blew me away,” said Dr. Galal. He is optimistic not only about Callemyn’s future, but also about the future for CAR T-cell therapy. This includes versions of T-cells that could shorten wait times for very sick patients and using interleukins -- proteins that regulate immune responses -- to improve outcomes after the treatment.
Callemyn is also pleased with her good health. “I expected to have to deal with this for years, but one year after I got sick, I feel great. I love to be outdoors, love to see things get accomplished. Thanks to Dr. Galal and the rest of the team, I can do that again.”
