Lichtgedanken 05

S C HW E R P U N K T 35 05 | LICHT GEDANKEN Therapy for Yuna When she was just ten weeks old, doc- tors diagnosed Yuna with a rare acute lymphoblastic leukaemia (ALL). They also found signs that are typical of an acute myeloid leukaemia (AML). Acu- te leukemias are malignant diseases of the haematopoietic system. The leu- kaemia cells suppress the normal blood formation in the bone marrow. Neither special chemotherapy nor an antibody therapy at a clinic in Valencia did not take effect against the persistent leu- kaemia. But her parents did not give up. Short- ly before Yuna was born, they had emigrated to Spain from Germany. They were searching for a hospital in Germany that would be able to help their daughter with the transplantati- on of haematopoietic stem cells. They received ten rejections from other hos- pitals in Germany before receiving a positive response from the Jena Uni- versity Hospital. »As Yuna was still relatively well at that point, despite her illness, we saw an op- portunity to help her by transplanting blood stem cells«, says Prof. Dr Bernd Gruhn from the Paediatrics unit. The 50-year-old Bavarian was found to be an ideal stem cell donor. Individually tailored antibodies effectively destroy leukaemia cells In order to reduce the risk of relapse after a transplant, the number of leu- kaemia cells must be reduced as far as possible in advance. Since chemothera- py had not worked in Valencia, the Jena paediatric oncologist opted for antibo- dy therapy targeted specifically at Yu- na’s leukaemia cells. The young patient was given the medicine each week via an intravenous drip. Three different antibodies—»gemtuzumab«, »dara- tumumab« and »inotuzumab«—were used and carrying the active substance, a toxin, to the leukaemia cells to dest- roy them effectively. »It is not just the combination of these antibodies, it is also the use of the drugs daratumumab and inotuzumab that The little Yuna and her parents can finally smile again. Following an eight-month-long treatment in the Paediatrics unit at the Jena Univer- sity Hospital, the 17-month-old toddler is now free from leukaemia cells. It has been a long journey to get to this point. Jena physicians saved Yuna’s life with individually tailored antibody therapy. BY ANNE CURTH On the photo on the right, a paediatri- cian Prof. Dr Bernd Gruhn was able to treat Yuna’s rare, immature, and acute lymphoblastic leukaemia with targeted antibody therapy. Yuna’s father is on the left. was special, as no child had been trea- ted in this way in Jena before, and only a few in Germany«, explains Gruhn. The individualized antibody therapy was successful. Following the last in- fusion, there were no further traces of leukaemia cells in the bone marrow. Combination of four medicines used for the first time in Germany But the actual transplantation of blood-forming stem cells was still to come. In order to ensure that the new blood stem cells were not rejected, Yu- na’s own bone marrow had to be dest- royed and her immune system suppres- sed. For this purpose and the first time in Germany, the Jena-based physicians used a combination of four different medicines. They then transplanted the donor’s bone marrow into Yuna. Yuna underwent intensive examinations 30, 60, 100, and 150 days later—always with the same result: her bone marrow is free of leukaemia cells.  F E AT U R E