Fighting Back: David's Journey Through Multiple Myeloma With CAR-T Cell Therapy

On an outing with his wife Kathy in August 2020, David Henbest from Tulsa fell and injured his back. Over the next five months his back worsened and the pain spread to his ribs. Kathy, a retired critical care nurse, insisted on an MRI. The results showed multiple compression fractures of his spine and ribs. Kathy noticed a vertebra seemed to be missing when she ran her hand down David’s spine.

Further tests revealed issues with David’s bloodwork. He was advised to see an oncologist, however, with the COVID-19 pandemic underway, David’s primary care physician sent the results of the blood tests to an oncologist in Tulsa. After examining the test results, the oncologist had a conference call with David and Kathy and informed them of the diagnosis — David had multiple myeloma.

What is Multiple Myeloma?

Multiple myeloma is a type of blood and bone cancer that targets plasma cells which are crucial for the immune system. Normally, healthy plasma cells produce antibodies to fight infections.

In multiple myeloma, cancerous plasma cells accumulate in the bone marrow, crowding out healthy blood cells. Instead of producing functional antibodies, the cancerous cells create defective proteins, leading to complications.

David’s “missing” vertebra — the sixth thoracic vertebra (T6), had been dissolved by the multiple myeloma. The compression fractures to his spine and ribs were also due to the disease. In March 2021, David underwent spinal surgery to repair the damage. The T6 vertebra had been dissolved to a small, sharp sliver of bone which was pressing against his spinal cord, risking paralysis. A titanium rod was placed in his back, and he started chemotherapy two weeks after surgery.

Treatment for Multiple Myeloma

David underwent four rounds of chemotherapy and radiation over two years, but the myeloma continued to progress. When initial treatment fails, it is called primary refractory multiple myeloma. If the cancer initially responds to treatment but later becomes resistant and starts growing again, it’s known as relapsed/refractory multiple myeloma.

Many multiple myeloma patients will eventually develop refractory disease. While the exact percentage of patients who develop refractory myeloma is not always detailed, it is known that a significant portion of patients experience this condition. With the diagnosis of refractory multiple myeloma, David was a candidate for CAR-T cell therapy, which he began in March 2023.

CAR-T Cell Therapy for Refractory Multiple Myeloma

CAR-T stands for Chimeric Antigen Receptor T-cell therapy, a process that enhances the T cells’ ability to target and destroy cancer cells.

The process starts with patients having their blood drawn. The blood is then processed to separate out the white blood cells, including the T cells, while the rest of the blood is returned to the patient. The T cells are sent to a lab where a special gene is inserted, enabling them to recognize and attack cancer cells more effectively.

Once modified, the T cells are sent back to the hospital and reinfused into the patient, similar to a blood transfusion. The infusion takes about an hour.

CAR-T cell therapy is considered one of the best options for refractory multiple myeloma for several reasons:

High Response Rates

CAR-T cell therapy has shown impressive results, with overall response rates around 83% and complete response rates of about 50%. This means many patients see significant improvement.

Durable Responses

The benefits of CAR-T therapy often last a long time. Many patients experience a response lasting over a year, which is valuable for those who have tried other treatments without success.

Targeted Therapy

CAR-T cells are specially engineered to target and destroy myeloma cells, while sparing healthy cells. This targeted approach can lead to fewer side effects compared to traditional chemotherapy.

Minimal Residual Disease (MRD) Negativity

A high percentage of patients achieve MRD negativity, meaning no detectable cancer cells remain after treatment. This is a strong indicator of long-term remission.

Improved Quality of Life

Many patients experience an improved quality of life due to the effectiveness of CAR-T therapy in controlling the disease and reducing symptoms.

Under the care of Stephenson Cancer Center hematologist/oncologist Dr. Taha Al-Juhaishi, M.D., assistant professor in the Department of Hematology-Oncology at the University of Oklahoma College of Medicine, David underwent CAR-T therapy. He tolerated it well and suffered mild symptoms of cytokine release syndrome (CRS).

CRS is an immune overreaction after treatments or infections, causing widespread inflammation. Symptoms may include fever, fatigue, nausea, low blood pressure, and shortness of breath.

Remission

A month after the infusion, David’s readings showed no active cancer. Dr. Al-Juhaishi noted that patients who benefit from CAR-T typically respond within a month or two.

David’s last appointment with Dr. Al-Juhaishi was in April 2024, and he remains in remission.

“David is a 78-year-old gentleman who was very frail and fatigued from the cancer and treatments when he started the therapy,” said Dr. Al-Juhaishi. “Without CART-T, he would probably be completely disabled and in hospice. Now he is feeling good and can do the things he enjoys.”

Through David’s treatment, Kathy was by his side, encouraging him to stay positive and upbeat.

“My theory is, don't give up hope,” said Kathy. “Don't let your spirits get destroyed by this. We worked really hard to keep our spirits up and not get doomsday thoughts. I did have at the back of my mind that I may lose my honey, but I didn’t let it destroy me. You must stay positive.”

Stephenson Cancer Center for CAR-T Cell Therapy

OU Health Stephenson Cancer Center is Oklahoma’s only cellular therapy and comprehensive stem cell transplant program accredited by the Foundation for the Accreditation of Cellular Therapy to serve people of all ages.

“We're the only place that offers CAR-T cell therapy in Oklahoma and our team has a great deal of experience and expertise with treating cancer patients,” said Dr. Al-Juhaishi.

David and Kathy are delighted with the treatment they received at Stephenson Cancer Center.

“On a scale of one to 10, we’d give Stephenson Cancer Center a 14,” said David. “Everyone there is so wonderful — the doctors, all the staff. Everyone was outstanding.”

Learn more about CAR-T advanced cellular therapy, make an appointment or seek a second opinion at Stephenson Cancer Center at (405) 271-1112.