Targeting IL-6: How A Drug That Helped a 6-Year-Old Beat Cancer Can Save COVID-19 Patients

In 2012, a 6-year-old girl named Emily Whitehead was battling acute lymphoblastic leukemia (ALL), one of the most common cancers in children. Her cancer was stubborn. After 16 months of chemotherapy, the cancer still would not go into remission. There was nothing else the doctors could do, and she was sent home. She was expected to survive only a few more months. Her parents would not give up and enrolled her into a clinical trial of a new immunotherapy treatment called chimeric antigen receptor (CAR) T cell therapy. She was the first pediatric patient in the program.

Doctors took T cells from Emily’s blood and reprogrammed them in a lab. They essentially sent her T cells to boot camp where they are trained to find cancer cells and destroy them. The reprogrammed T cells were then injected back into her body. A week into treatment, she started getting a fever, the first sign that the treatment was working and her reprogrammed T cells were fighting the cancer. But soon, she got very sick. All of the indicators suggested that she had cytokine release syndrome (CRS)—also known as the cytokine storm. This happens when cytokines are released in response to an infection but the process cannot be turned off. The cytokines continue to attract immune cells to the infection site, causing damage to the patient’s own cells and eventually resulting in acute respiratory distress syndrome (ARDS). (Learn more about the cytokine storm in this blog.)

Emily was soon on a ventilator. Tests showed that she had extremely high levels of one particular cytokine: interleukin-6 (IL-6). Desperate to keep her alive, her doctors gave her a known drug that specifically targets IL-6. The results were dramatic. After one single dose, her fever subsided within hours, and she was taken off the ventilator. On May 2nd, 2012, she woke up from an induced coma—it was her 7th birthday. Her doctors said they have never seen a patient that sick get better that quickly.

The drug that saved her life was tocilizumab.

Continue reading “Targeting IL-6: How A Drug That Helped a 6-Year-Old Beat Cancer Can Save COVID-19 Patients”

The Cytokine Storm: Why Some COVID-19 Cases Are More Severe

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Blog Updated on June 16, 2020

One of the biggest outstanding questions of the COVID-19 pandemic is why symptoms vary so much among patients. Some patients have no symptoms at all; some symptoms are mild, while others are extremely severe. Among the more severe cases, a common pattern of disease progression happens like this: A patient gets through the first week with some signs of recovery—then suddenly they rapidly deteriorate. In some cases, they go from needing just a tiny bit of oxygen to requiring a ventilator within 24 hours.

This pattern, often seen in young and otherwise healthy patients, has baffled doctors. What causes these patients to suddenly crash? Research now suggests that the patient’s own immune system may be to blame. It’s called cytokine release syndrome—also known as the “cytokine storm”.

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Real Life Research Stories That Inspire

29980706-AugustBlog-QuestionThree weeks ago the journal Science ran a fascinating story about a young doctor fighting to cure his own rare and deadly disease. I clicked on the link to the article and was immediately drawn into the saga of David Fajgenbaum. The journalist, Jennifer Couzin-Frankel, tells the riveting account of Fajgenbaum who, in his third year of medical school at the University of Pennsylvania, learned that his organs were failing, quickly. His health had been deteriorating for a few weeks prior, and he knew something was seriously wrong. Yet as a medical student in the midst of his obstetrics-gynecology rotation, he had little time to focus on his own mysterious symptoms.

The story goes on to describe in detail how Fajgenbaum, now 31 years old, and his dedicated team of physicians continue to try to solve the mystery of his potentially fatal illness. The first time his liver, kidneys and bone marrow were found to be malfunctioning he landed in the ICU for nearly seven weeks. There he suffered a retinal hemorrhage that caused temporary blindness. But that was only the beginning. Continue reading “Real Life Research Stories That Inspire”