One Patient's Recovery From Mantle Cell Lymphoma with CAR T-Cell Therapy

Jason Owens has been in sight of death's door before. But in spring 2022, he was close enough to ring the doorbell.

A double organ transplantee, Owens had overcome a series of health scares since receiving a pancreas and kidney in 2010. This time, however, the Myrtle Beach resident was diagnosed with mantle cell lymphoma, an insidious and rare type of lymphoma that is difficult to treat.

 

The diagnosis caught Owens, 45, by surprise.

"I didn't have any symptoms, which is typical of mantle cell lymphoma," he says. "In March of that year, I had gone for routine blood work to make sure my blood levels were where they should be since my double transplant."

Owens' doctor noted that his white cell count was extremely high and referred him to an oncologist in Little River. The oncologist told Owens that he suspected lymphoma and treatments were beyond his scope. He referred Owens to MUSC Health.

Treating Mantle Cell Lymphoma

Within days, Owens was in the office of MUSC Hollings Cancer Center's Dr. I. Brian Greenwell, a hematologist and medical oncologist with expertise in lymphoma, and physician assistant Amanda Herbst. "My referral was fairly quick because the type of lymphoma I had was very aggressive," Owens says. More testing confirmed the diagnosis: mantle cell lymphoma, for which there is no cure.

Owens began a regimen of oral chemotherapy but was unable to tolerate it. Next, he went on a weekly infusion and oral BTK inhibitor, which didn't work the way his doctors had hoped. As a solid organ (the kidney, liver, intestines, heart, lung and pancreas are solid organs) transplantee, he did not qualify for an allogeneic stem cell transplant because of the high risk of rejection.

With no improvement in Owens' condition and time and treatment options running short, Dr. Greenwell recommended CAR T-cell therapy, a procedure in which an individual's T-cells are removed, shipped to scientists at a pharmaceutical company where they are engineered with a chimeric antigen receptor (CAR gene), tested, cryopreserved, shipped back to MUSC Health and reinfused into the body.

CAR T-Cell Therapy: Hurdles to Clear and a High-Risk Decision

Owens would be MUSC Health's first double transplantee to undergo CAR T-cell therapy. But first, he had to clear another hurdle.

"I had to be approved because I have a lot of risk factors since I was a double transplantee," he says. "Dr. Greenwell fought for me to get treatment. I was at extremely high risk because I had to be on immunosuppression medication, and I had to stop that while I went through CAR T treatment. I had a lot going on that could have gone wrong."

Once he was approved, the process moved quickly. Owens' T-cells were removed at MUSC's NCI-designated MUSC Hollings Cancer Center. Although the process was painless, it lasted a few hours. Three weeks later, in May 2022, Owens' engineered cells were returned to MUSC, and he began three days of IV chemotherapy to help prepare his body for the CAR T cells to expand.

Almost immediately after receiving the infusion of engineered cells, Owens' body began rejecting his donor pancreas and kidney.

Doctors took a risk and gave him high-dose steroids. The risk paid off; the steroids worked.

"Doctors and scientists learned that steroid treatment can be used with CAR T, so in the future, this treatment should help prevent organ rejection," Owens says.

"MUSC Truly Saved My Life"

Meanwhile, Owens continued to recover. A CT scan in June 2022 indicated the CAR T-cell therapy was working. A second scan in August 2022 showed that he was in remission, progress that has been confirmed by subsequent scans every three months.

 

A self-described "standard guy," Owens has resumed attending a men's group at his church, occasionally teaching Sunday school and rooting for his hometown Pittsburgh Steelers and the University of North Carolina Tarheels basketball team.

Owens says he is grateful for the treatment he received from the MUSC Health staff. He is convinced he couldn't have found better treatment anywhere else.

"The care was phenomenal," he says. "I wasn't a number; I was a person, and they treated us like family. Dr. Greenwell explained everything to me in complete detail – the risks and the benefits – and he left the decision up to my wife and me. And he kept me abreast of what new treatments may be coming out in the future in case I need them."

Owens says MUSC Health saved his life. "I didn't have any other options," he says. "CAR-T was my last treatment, and when you're looking at death's door, it is very hard. Our daughter is only 10, and being around for her and Meghan is what matters most to me.

MUSC truly saved my life."

Blood Cancer and MUSC Health

According to the CDC, hematologic cancers, or blood cancers, begin in the cells of the immune system or blood-forming tissue, such as the bone marrow. Common types of hematologic cancer are lymphoma, myeloma and leukemia.

At MUSC Hollings Cancer Center, our blood and lymphatic cancer doctors specialize in diseases of the blood and blood-forming organs, including acute and chronic leukemias, myelodysplastic syndrome, Hodgkin lymphoma, non-Hodgkin lymphoma, cutaneous lymphoma and myeloma.

We know a cancer diagnosis can be a life-changing event. We are here to support you through your journey. Call 843-792-9300 and make an appointment. Visit MUSC Hollings Cancer Center's Blood & Lymphatic Cancer website to learn more.