A promising therapy for people with recurring non-Hodgkin lymphoma and pediatric/young adult acute lymphoblastic leukemia was recently approved by the Food and Drug Administration (FDA) and is now available for commercial use at Nebraska Medicine.

“This is a big home run for patients who have failed every other type of cancer treatment,” says Julie Vose, MD, chief of Hematology/Oncology at Nebraska Medicine.

Nebraska Medicine, which has a nationally recognized lymphoma program, was one of the first centers in the Midwest that provided chimeric antigen receptor (CAR) T-cell therapy through clinical trials. The therapy is part of growing treatment options in cancer that harness the body’s own immune system to attack a tumor.

“T cells are white blood cells that help our bodies fight infection and cancer,” explains Dr. Vose. “In some patients with lymphomas and leukemias, their T cells don’t recognize the cancer as being abnormal and this allows the cancers to grow. This new therapy allows us to take the patient’s own T cells outside the body and re-stimulate them to fight their own cancer.”

Amy Cheese of Fort Collins, Colorado, was out of options before coming to Nebraska Medicine in November 2016. The third-grade teacher was battling non-Hodgkin lymphoma and had a grapefruit-sized tumor in her chest. After receiving CAR T-cell therapy, Cheese is now in remission and back to teaching.

“I can’t stop smiling,” she says. “Knowing CAR T-cell therapy is commercially available makes me think of all the people who will not have to hear the words, ‘there is nothing else we can do.’”

“We are really excited about offering this new therapy to our patients,” says Matthew Lunning, DO, Nebraska Medicine hematologist/medical oncologist. “Nebraska Medicine has been involved from the ground floor in developing this therapy and we are now able to offer it on a large scale. Nationwide, patients with non-Hodgkin lymphoma who have received this therapy have had a complete remission rate of nearly 40 percent after six months. This is significant as these are patients who have failed other possible therapies available.”

Treatment for newly diagnosed non-Hodgkin lymphoma and acute lymphoblastic leukemia patients typically starts with chemotherapy. The relapse rate for first time treatment of non-Hodgkin lymphoma is 30 percent and 40 percent for acute lymphoblastic leukemia. The majority of these patients will then go on to receive a blood or bone marrow transplant, of which about half of patients will relapse. Patients who relapse after the transplant or are not candidates for a transplant may be potential candidates for CAR T-cell therapy.


During the first phase of CAR T-cell therapy, the patient’s T cells are collected at an outpatient procedure at the hospital. The cells are then sent to a pharmaceutical company lab where they are genetically modified and grown until there are millions of them. The process in the lab takes about two to six weeks. When the cells are returned to Nebraska Medicine, they are placed in a specialized processing center to complete the procedure. In the meantime, the patient receives several days of chemotherapy. The modified CAR T cells are then infused into the patient where they multiply, attack and kill the cancerous cells. The CAR T cells, which remain in the body long after the infusion has been completed, help to prevent the lymphoma or leukemia from relapsing.

“The selection of candidates for this therapy needs to be rigorous,” says Dr. Lunning, “and the process needs to be done at a center that has specific expertise in this area due to the potential for severe side effects and toxicities that can be harmful to the patient unless monitored and treated appropriately.”

All Nebraska Medicine staff involved in the therapy have had to undergo and pass a training program before Nebraska Medicine could be approved to administer the treatment. Nebraska Medicine is the only health care network in Nebraska to offer CAR T-cell therapy.

“The good news is that we are getting better at treating, detecting and managing toxicities and we will continue to improve with more experience. The potential for this new therapy is very promising. We hope to be able to expand it to the treatment of other cancers like multiple myeloma and solid tumors eventually,” says Dr. Lunning.

To find out if you’re a candidate for this new therapy, please call Nebraska Medicine at 402.559.5600 to schedule an evaluation.

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