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MEDICAL HISTORY Anthony Herrera was diagnosed with Mantle Cell Lymphoma in January of 1997 and was told at New York University Hospital, "There is nothing we can do. You are going to die." He then went to Memorial Sloan-Kettering and was treated with a regimen of chop and ICE chemotherapy and total body irradiation. On August 1, 1997 he received an autologous stem cell transplant and was found to be in remission. In November 1998, he relapsed and received four cycles of chemotherapy. On March 30, 1999 he was admitted to the University of Texas, M.D. Anderson Cancer Center in Houston Texas, under the care of Dr. Issa Khouri, M.D. He underwent an allogeneic stem cell transplantation using a non-myeloablative regimen. His brother John, was his donor. He required a boost of donor lymphocyte infusion after transplantation. He then suffered from CMV,
a mild stroke and a seizure. This treatment was based on a concept developed at M.D. Anderson Cancer Center, that many neoplastic diseases can be treated by immune modulation only without the need for toxic high dose chemotherapy. Up until recently high dose chemotherapy was considered essential for marrow or stem cell transplantation. This new treatment offers new hope and new horizons for patients suffering from this otherwise fatal disease. Mr. Herrera relapsed August 15, 2000. He then worked with Dr. Ira Braunschweig, formerly of MD Anderson Cancer Center, now medical director of The Center for Medical Oncology in Garden City New York. The plan at that time was to use Rituxan to control the lymphoma and then return to MD Anderson for a donor lymphocyte infusion. A CAT-scan from September 27, 2000 showed less disease without any treatment of any kind. This meant that his new immune system had started battling the disease. This was a medical history in the treatment of Mantle Cell Lymphoma in that the new immune system had started killing lymphoma cells and there by reducing the amount of disease without treatment of any kind. Dr. Braunschweig and Herrera debated and then decided to proceed with four rounds of high dose Rituxan during the month of October, with the hope that the Rituxan would assist his new immune system in the battle. CAT scans and Gallium scans that followed from November through 30 January 2001 showed a steady decrease in the amount of lymphoma and lymphoma related activity. Herrera and Dr. Braunschweig have discussed several times whether there was a chance the rituxan aided his new immune system in the battle to control the Mantle Cell Lymphoma. They will never know. What is concluded by Dr. Braunschweig, Dr. Andre Goy, Dr. James Gajewski and Dr. Sergio Giralt is that the donor infusion of Herrera’s brother’s cells and the assimulation of this new immune system in his body that has kept Herrera in remission for five years. This unexpected development of Graft vs. Lymphoma approach is positive news for fighting cancer and other life threatening diseases. GRAFT = NEW IMMUNE
SYSTEM
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