「The owners continue to be satisfied.」
J：Next, I would like to ask you in depth about the actual treatments you have performed. What kind of cases have you treated so far?
Arii：So far, we have performed three cases of activated lymphocyte therapy (CAT), one of which unfortunately died in the process, and two of which are still undergoing treatment with activated lymphocyte therapy.
J：If you continue to do so, you must feel satisfied with the service.
Arii：Yes, the first case was a mast cell tumor of the spleen in a cat. Surgery was performed, but it had metastasized to the liver, and a short time after the surgery, ascites fluid accumulation began, and the prognosis was grim. The prognosis was grim. We presented three options: anticancer drugs, no treatment, or activated lymphocyte therapy. We presented three options: anticancer drugs, no treatment, or activated lymphocyte therapy.
This owner’s previous dog had also died of lymphoma of the spleen. At that time, he was treated with anticancer drugs after surgery. The dog was completely cured with a combination of multiple anti-cancer drugs, and when the cancer recurred, rescue therapy was also performed, but there were several side effects during the course of the treatment, and the owner was concerned about them. In addition, this time the cat also had side symptoms such as chronic kidney disease, hypothyroidism, and liver hypofunction, so she did not want to be treated with anticancer drugs. We performed activated lymphocyte therapy in the hope that there would be no side effects.
J：Some owners have seen their family members being treated with anticancer drugs and would like a treatment with fewer side effects. What was the clinical response of the patients?
Arii：Before the cell administration, I had ascites fluid after the operation, but that has gone away. I had expected that the course of the disease would never be good because of the hypertrophic cardiomyopathy that was concomitant with the disease, the pleural effusion, and the obvious metastasis to the liver that was confirmed during the surgery, but he has been alive for 9 months since the operation to the present.
It is said that visceral mast cell tumors can last up to a year after surgery, but I wonder if a child who has accumulated ascites fluid since surgery could have been maintained so well with surgery alone, so I am wondering if it is the effect of cell administration. The tumor is in the terminal stage, but in spite of that, he is eating heartily and does not seem to be in any pain. The owner is satisfied with the results. The owner of the cat, which also had bad kidneys and hyperthyroidism, wanted the best for its general condition. In that sense, I feel that we were able to meet their needs. We are now administering lymphocytes once every two months to control the condition.
J：What about the other two examples?
Arii：In the other two cases, the owners also had the satisfaction of having done so.
One case was a patient with nasal adenocarcinoma that had invaded the brain and caused seizures and other neurological symptoms. Due to the difficulty of the location of the tumor, the owner was not willing to undergo surgery or radiation therapy. Therefore, we talked about activated lymphocyte therapy because it might suppress the progression of symptoms and prolong the survival period. The child died after completing one course of treatment (six doses given once every two weeks), but his seizures almost stopped after the administration. Before administration, he had frequent seizures even when taking antiepileptic drugs, but after administration, they decreased, and we believe that the activated lymphocytes may have been effective.
The other case is angiosarcoma of the spleen in a dog. CAT is being performed in combination with metronomic therapy (dormant chemotherapy) at the time of surgery. The median survival is about 6 months, and this case is also 6 months old, but there is no sign of recurrence at all, so we believe this is also a response. We continue to administer the drug once a month, as requested by the owner.
J：In all three cases, the doctor himself and the owners have continued to be satisfied with the results. What do you tell the owners when you propose this treatment?
Arii：The first thing I will tell you is that there are no major side effects. I also tell them that it is difficult to eliminate cancer cells, but it may be possible to control the progression of the disease. This may be due to the regional characteristics of the area, but when I explain this to them, many of the owners readily agree and say, “By all means, I would like to have this treatment.
J：I feel that cell therapy is a treatment that requires a great deal of trust between the veterinarian and the patient when proceeding. I see that the owners are convinced by what the doctor has to say.
「I like to grow things, so it’s nice to see more cells.」
J：Next, I would like to ask about culture. The doctor has prepared a room for cell therapy and has secured a large space for a hospital culture room.
Arii：It’s just right for the place.
J：Did you have any difficulties in cell culture operation?
Arii：When I first went there, there was not much increase, but there was no contamination and now it is increasing steadily and well. Looking back, I am not sure what was different. I have become accustomed to the culture after having done it a number of times, so I don’t have much time to spend on culture operations.
J：Although two part-time veterinarian doctors can be seen at your hospital, the director is in charge of all cell culture operations. Is there any interference with the doctor’s daily examination duties?
Arii：So far, there are none. We are culturing as if it were an operation during lunch breaks, etc. Activated lymphocyte therapy (CAT) doesn’t take much time. I try to be conscious and careful when taking blood samples, such as by clipping the hair and disinfecting children with slightly bad skin in the same way as when operating on them.
J：Some doctors want to recommend cell therapy at their own hospitals, but are reluctant to do so because of the hassle of culturing the cells themselves.
Arii：The culture itself is nothing fancy, and you may or may not like it. I like to grow things, and I am happy when they are growing well.