[HN Gopher] 'It's all gone': CAR-T therapy forces autoimmune dis...
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       'It's all gone': CAR-T therapy forces autoimmune diseases into
       remission
        
       Author : kevinmchugh
       Score  : 103 points
       Date   : 2023-12-14 18:46 UTC (4 hours ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | awestroke wrote:
       | > CAR-T therapy can have severe side effects, and recipients must
       | first undergo intensive chemotherapy that kills off many of their
       | existing immune cells.
       | 
       | Damn, that really seems like a last resort.
        
         | dakial1 wrote:
         | I understand that is similar to any chemotherapy no? But your
         | body will rebuild it after ~30days.
        
         | dylan604 wrote:
         | chemo is well known for the treatment being worse than the
         | disease...in the short term. when it works, the long term
         | effect is well worth it.
        
           | BizarroLand wrote:
           | Yeah, I wouldn't undergo chemo for something like eczema or a
           | simple food intolerance, but if it were something like lupus
           | or Guillain-Barre syndrome I would seriously consider it.
        
         | JumpCrisscross wrote:
         | > _that really seems like a last resort_
         | 
         | Have we had a compelling reason to research drugs whose primary
         | purpose is to kill bone marrow in healthy patients before?
        
           | chefkoch wrote:
           | Sure we have, melphalan is being used to treat multiple
           | myeloma for decades now.
           | 
           | Kill all the cancer in your bone marrow and transplant new
           | stem cells to regrow it.
        
           | hinkley wrote:
           | Several forms of immune system cancer treatment involve
           | nuking the immune system and getting a bone marrow transplant
           | from a healthy donor.
           | 
           | Leukemia for sure, and I think also a few kinds (or at least
           | stages) of lymphoma.
        
         | Broken_Hippo wrote:
         | I have MS. I'm in my mid-40s and have few day-to-day symptoms.
         | I'm fairly lucky so far.
         | 
         | But that could all change tomorrow. Some years ago, I woke up
         | and couldn't see out of my right eye. It got better, but it
         | took months to heal (and I was kind of lucky with that, too). I
         | still have reduced grip strength from a 'flare' a few years
         | back. What next? All it takes is one flare to make my life more
         | difficult forever.
         | 
         | The current medicines tend to reduce disease activity - which
         | means most folks have less disability and more mobility than in
         | previous decades - and all have some side effects, which vary
         | in intensity. At least there are pills now: The older drugs
         | were injected at home and tended to make folks feel even worse
         | than modern drugs.
         | 
         | Last resort? Not really. It might be worth the risk of chemo
         | just to not have to have this sort of uncertainty every day. I
         | know chemo brings its own risks, but at least there is a more
         | clear path on what might happen.
        
       | lolc wrote:
       | As a carrier of another autoimmune disease, I will be tempted to
       | flip that switch should it become available. Since I participate
       | in pretty much all studies they offer me, I would consider
       | joining that one too. It might be the last one they'd ask me in
       | for!
       | 
       | On the other hand, the disease is not debilitating for me. I'll
       | also consider waiting and let a few fellow diabetics try first
       | :-)
        
       | voidpointercast wrote:
       | What about leukemias?
        
         | vikramkr wrote:
         | That's what cd19 car t was already developed and FDA approved
         | for
        
           | navbaker wrote:
           | Anecdotal, but a former co-worker's young daughter was just
           | completely cleared of leukemia after several years of
           | treatments that didn't work followed by CAR-T
        
         | WhatsTheBigIdea wrote:
         | A good friend of mine was cured (knock on wood) of leukemia by
         | CAR-T. She was one of the first people to get it during a
         | clinical trial. She'd been through all the regular chemo, bone
         | marrow transplant, etc as well as 3 other (failed) experimental
         | treatments and was nearly beyond hope. It seems pretty certain
         | that CAR-T saved her life. I went hiking with her not too long
         | ago. Pretty amazing.
        
       | kmanlives wrote:
       | I have an autoimmune disease mentioned in the article. In looking
       | through a group of which I am member I came across this
       | interesting FDA alert about CAR-T therapy from a few weeks ago...
       | 
       | https://www.drugs.com/fda/fda-investigating-serious-risk-t-c...
        
       | MostlyStable wrote:
       | Still seems new and with relatively low sample sizes (although
       | hard to be sure since it sounds like it's been more widely used
       | than the work described in this paper), but potentially very
       | exciting, especially since it seems to be pretty broadly
       | applicable to a large number of auto-immune disorders.
        
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       (page generated 2023-12-14 23:01 UTC)