Black boxes and bumper cars
A lot has happened in the blood cancer world in the past few weeks, since the annual ASH meeting took place in Southern California. Just before the meeting, The FDA told us that leukemia is now officially a potential side effect of CAR-T therapy. CAR-T is the revolutionary therapy in which a patient's T cells are given antigens aimed at killing specific cancer cells, instead of all of one's cells. We also learned on December 8 that "all gene therapies," the first one of which was approved by the FDA on that day, carry leukemia as a potential side effect. Two steps forward, one step back. Revlimid, the mainstay of Multiple Myeloma chemotherapy, also has a black box warning that the drug can cause neutropenia (suppressed immune system), birth defects (it is thalidomide after all...), deep vein thrombosis, stroke, heart attack and leukemia. THEN there is a long list of precautions and warnings before we get to the 'adverse reactions' which...