Immunotherapy for childhood leukemia

Immunotherapy is sometimes used to treat childhood leukemia that doesn’t respond to other treatments or comes back after treatment. Immunotherapy helps to strengthen or restore the immune system’s ability to fight cancer. Immunotherapy is sometimes called biological therapy.

Your child may have immunotherapy to:

• kill leukemia cells or slow their growth
• strengthen their immune system
• lower the risk that the cancer will come back (recur)

The healthcare team will consider your child’s personal needs to plan the drugs, doses and schedules of immunotherapy. Your child may also receive other treatments.

CAR T-cell therapy is a type of immunotherapy used to treat childhood leukemia. It takes millions of T cells from a child with cancer. In the lab, the cells are changed so that they have chimeric antigen receptors (CARs) on their surface. These receptors recognize a specific antigen (protein) found on the leukemia cells. The T cells are then given back to the child where they multiply, attack and destroy the leukemia cells.

Tisagenlecleucel (Kymriah) is a CAR T-cell therapy used to treat children with B-cell ALL that does not respond to treatment or has come back after treatment. It may also be used to treat children with B-cell ALL that are unable to have a stem cell transplant.

Side effects can happen with any type of treatment for childhood leukemia, but every child’s experience is different. Some children have many side effects. Other children have few or none at all.

Side effects of immunotherapy will depend mainly on the type of drug or drug combination, the dose, how it’s given and your child’s overall health. Tisagenlecleucel may cause these side effects:

• low blood pressure
• flu-like symptoms, such as fever, chills, muscle and joint aches or pains, headache, nausea and vomiting or loss of appetite
• infection
• diarrhea
• tremors
• low potassium and phosphorus levels
• low blood cell counts

Tell your child’s healthcare team if your child has these side effects or others you think might be from immunotherapy. Side effects with immunotherapy can happen any time during, immediately after or a few days or weeks after immunotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

The healthcare team is there to help. The sooner you tell them of any problems, the sooner they can suggest ways to help your child deal with them.

Other side effects can develop months or years after treatment for childhood leukemia. Find out more about late effects for childhood leukemia.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about immunotherapy. To make the decisions that are right for your child, ask the healthcare team questions about immunotherapy.