A six-year-old boy called Álvaro, from Alicante, who had type B acute lymphoblastic leukemia and was not responding to conventional treatment, has been cured and able to live a normal life thanks to a new genetic therapy called CAR-T 19, paid for by the public health service. Álvaro was treated at the Hospital Sant Joan de Déu (HSJD) in Esplugues de Llobregat (Barcelona), one of only three children's hospitals in Spain authorised to provide the CAR-T treatment. The others are the Vall d'Hebron hospital, also in Barcelona, and the Niño Jesús hospital in Madrid.
Álvaro is now back at home, after doctors told him he could "go back to living a full and normal life, and to enjoy it", said his mother Marina at the press conference. Also present were Dr Miquel Pons, the hospital's medical director, and Dr Susana Rives, the haematologist who has been treating the little boy. They explained the way the treatment had been used. Álvaro was diagnosed with acute lymphoblastic leukemia when he was very young, and after the usual treatment and a bone marrow transplant, the illness returned and he was referred to the Sant Joan de Déu hospital for CAR-T 19 treatment last autumn. Although he suffered complications and spent time in intensive care, Álvaro recovered and is now living normally with his parents and younger sister.
CAR-T 19 is a therapy which helps the patient's immune system to recognise, attack and destroy cancer cells in a guided manner. It consists of extracting blood from the patient by apheresis, a technique which enables the components of the blood to be separated in order to obtain T lymphocytes, a type of cell from the immune system. The T lymphocytes extracted from the patient are modified by genetical engineering techniques in the laboratory so they express the CAR-T receptor on the surface; this has the ability to recognise the tumoural CD19 antigen and destroy the cancerous cells.
Once modified genetically, through a process which can take from two to four weeks, the lymphocytes are transferred once again to the patient, who is able to lead a normal life after about three months.
Álvaro's is the first paediatric case of this type to have been financed under the public health system and it cost about 320,000 euros, explained Dr Pons, who also said that the HSJC has been carrying out this type of therapy since 2016.
In fact, Sant Joan de Déu was the only Spanish hospital to take part in the clinical tests which the multnational pharmaceutical company Novartis carried out around the world on CAR-T 19, with 16 paediatric patients. Of those patients, 80 per cent responded positively to the treatment.