Dennis B’s Immunotherapy Story

Leukemia

The T cell experience was a walk through the park. It was a piece of cake compared to the chemo and the transplant.

Dennis’s Story

Father Dennis Billy knows that suffering can sometimes be meaningful. As a Catholic priest and chair of moral theology at St. Charles Borromeo Seminary in Wynnewood, PA, Father Dennis knows that suffering brings us face-to-face with mortality and forces us to question why we’re here. He was used to counseling others through such tough times, but wasn’t quite expecting to face these issues for himself so soon.

In 2010, at the age of 56, Father Dennis was diagnosed with acute lymphocytic leukemia (ALL). ALL is a type of cancer caused by uncontrolled division of white blood cells in the bone marrow. The rapidly accumulating white blood cells begin to crowd out normal cells in the bone marrow, leading to fatal consequences if not treated quickly and aggressively.

Father Dennis’s doctors treated him with several rounds of aggressive chemo, but the cancer resisted this blunt weapon. His only real hope for a cure was to receive a bone marrow transplant, which would replace his defective bone marrow cells with healthy ones. But for that to happen, he would first need to be in remission from cancer.

Getting Father Dennis to the point of remission was the goal of a new immunotherapy technique called chimeric antigen receptor (CAR) T cell therapy, being developed at Memorial Sloan Kettering Cancer Center in New York by Cancer Research Institute—funded scientist Michel Sadelain, MD, PhD, and his colleague Renier J. Brentjens, MD, PhD

In this process, immune cells called T cells are collected from the patient’s own body, genetically re-engineered in the lab to recognize a specific marker of leukemia, and then given back to the patient. Once these CAR T cells have cleared the body of cancer, the patient can receive a bone marrow transplant.

Father Dennis’s bone marrow donor was his own brother, Richard, a retired New York City firefighter, who nearly died in the World Trade Center on September 11, 2001. Among Father Dennis’s siblings, Richard was the only compatible match. TheAnswertoCancer (TheA2C) talked to Father Dennis about his treatment journey to date.

Questions and Answers

How did you learn about immunotherapy and why did you decide to do it?

The doctors told me that the choice before me was to either continue with the basic kind of chemotherapy they were treating me with, and that had worked for a while. But they told me that eventually the leukemia would take control. And then there was a possibility of a more aggressive treatment. Dr. Castro-Malaspina said there was one more doctor he wanted me to see at Sloan Kettering, because a new clinical trial had just opened up. 

He asked me to see a Dr. Renier Brentjens, who was involved in this study on targeted re-engineered T cell therapy.

What was treatment like? Did you have any side effects?

I went to Sloan Kettering and they hooked me up to a machine which filtered my blood. In the filtering process they took out my T cells. As I understand it, in my layman’s knowledge, they then re-engineered the T cells to hook onto certain markers on my leukemia cells. T cells normally don’t identify your own body, they go after foreign substances. But they re-engineered the T cells to attack my own leukemia cells. I received the T cells on August 31, 2011.

As far as I remember, the T cell infusion itself didn’t have any bad side effects, maybe some fever. The side effects I do remember were from the bone marrow transplant. 

How did immunotherapy compare to other treatments you may have received, if any?

Oh, it was a walk through the park. It was a piece of cake compared to the chemo and compared to the transplant. Dr. Brentjens told me jokingly that he viewed his job as putting the transplant doctors out of work. They want to develop [the T cell technique] and perfect it to a point where transplants wouldn’t even be needed.

Are there things that surprise you about the cancer experience?

My advice would be to talk it through with your doctors and people who care for you. If you are a spiritual person, I would also suggest you bring the situation to God. I would add that you already know the outcome of what non-treatment will be. It’ll be that the leukemia is eventually going to take its course. By participating in a clinical trial you may possibly not only reap benefits for yourself but for other people and for science.