Acute lymphoblastic leukemia, or ALL, a cancer of the blood and bone marrow, is the most common of all childhood cancers. The good news is that eighty-five percent of children with ALL are cured after a two-year process with standard chemotherapy. Fifteen percent, however, are not as lucky. Seventeen-year-old Nicholas Wilkins was first diagnosed with ALL in 2002, when he was just four years old. At seven, after undergoing standard treatment, Nicholas was in remission and his life normalized. He was happy, active in sports and doing well at school.
When he was eleven, however, his medical condition changed. He began having stomach pains and when he played sports, he would quickly get winded. By a fortunate twist of fate, Nicholas injured his ankle playing football, which resulted in a visit to the emergency room. Blood work during the hospital visit revealed that his leukemia had returned. Nicholas was soon back into treatment, completing an intensive nineteen-week course of chemotherapy and radiation. Four months in the hospital forced him to miss sixth grade at school. The treatments triggered a wave of complications and challenges, including serious lung infections. Finally, on January 26 2010, Nicholas received a bone marrow transplant—his older sister, Brittany, was his donor. Again, Nicholas was able to return to school in Virginia, apparently cancer free.
This remission was short lived and in 2013, his ALL returned. Having exhausted all traditional ALL therapies, Nicholas was enrolled in a clinical trial at the Children’s Hospital of Philadelphia (CHOP) that was using chimeric antigen receptor T-cells, or CAR T-cell therapy. In the revolutionary but experimental treatment, millions of Nicholas’s T-cells were collected from his blood, then reengineered in a laboratory. Once the cells were infused back into him, they would disperse to find and kill all cancerous cells. On May 21 2013, Dr. Susan Rheingold, medical director of the Oncology Outpatient Clinic at CHOP, infused the T-cells. When the first test results came back, Nicholas was in remission. He had completely responded to his T-cell therapy. Three months and again at six months out from his treatment, he had no leukemia whatsoever. The cancer-fighting T cells were still there in his body and he was cancer free, hopefully forever.