NPR | Dr. Siddhartha Mukherjee still remembers the first cell he cultured: It was an immune cell from a mouse, and he had grown it in a petri dish. As he examined it through a microscope, the cell moved, and Mukherjee was fascinated.
"I could sense the pulse of life moving through it," he says. "You suddenly realize that you're looking at the basic, fundamental unit of life and that this blob that you're seeing under the microscope — this glimmering, refulgent blob of a cell — is the basic unit that connects us and plants and bacteria and archaea and all these other genera and taxa across the entire animal and plant kingdoms."
As an oncologist, cell biologist and hematologist, Mukherjee treats cancer patients and conducts research in cellular engineering. In his new book, The Song of the Cell, he writes about the emerging field of cell therapy and about how cellular science could one day lead to breakthroughs in the treatment of cancer, HIV, Type 1 diabetes and sickle cell anemia.
Mukherjee has a particular interest in T cells — a type of white blood cell and part of the immune system activated to fight disease. He's been treating patients in India who have certain types of cancer with genetically engineered T-cell variants, and the results have been striking: "One day the cancer's there. The next day the cancer is virtually gone, eaten up by these T cells," he says.
Genetically engineered T cells, known as CAR [chimeric antigen receptor ] T cells, have become a staple in the treatment of certain kinds of leukemias, lymphomas and blood cancers. But, Mukherjee says, the cells have not yet proven effective in combatting the solid tumors, like those associated with lung and prostate cancer. His hope is that further research might change that.
"It's hard for me to convey the excitement that's sweeping through the whole field of cell biology ... the kind of headiness, giddiness, the madness, the psychic power that grips you once you get into the field," Mukherjee says.
Interview highlights
On using CAR-T cell therapy to treat Emily, a child with leukemia
[The treatment is] we extract the T cells from the from a patient's body. And then we use a gene therapy to basically weaponize them, to activate them and weaponize them against the cancer. We grow the T-cells in flasks in a very, very sterile chamber. And then ultimately when the cells have grown and activated, we re-infuse them into the patient's body. So it's sort of gene therapy plus cell therapy — given back to a patient.
In Emily's case, she was about 7, I think, when she was first treated. She had a complete response. She also had a very terrifying course. When the T cells get activated, they release an incredibly inflammatory cascade, sort of like, as I say in the book, it's sort of like soldiers on a rampage. And you can get so much of a rampage of T cells killing cancer that body goes berserk, it can't handle this kind of attack. Now, Emily, fortunately, was treated with a medicine to dampen down that attack so that she ultimately survived. She was the first child treated with this therapy to survive and serves an icon for this kind of therapy. ... She still is alive today and applying to colleges, I hear.
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