Rosemarie’s Story: Beating Back Multiple Myeloma with CAR-T Therapy

For Rosemarie Fileen, something was amiss. “This was around 2017, and I was not feeling 100% myself,” recalls the now 51-year-old working mother of three. “I felt lethargic, and I had pain throughout my body. But it felt more like a bone pain, along with a lot of fatigue. And I was getting sick a lot, with colds and a chronic cough.”

Finally, after months of visits with several doctors and a battery of bloodwork, a clue emerged.

“I remember the call,” Rosemarie says. “It was a Friday night, and I remember the doctor saying I had a protein in my blood. She said it was concerning, and she recommended that I see a hematologist. That’s when I made my first appointment at Columbia.”

Diagnosis: multiple myeloma

Rosemarie’s medical oncologist at Columbia was hematologist Divaya Bhutani, MD. As Rosemarie recalls, “Dr. Bhutani was very responsive. He ordered a bone marrow biopsy and CT and PET scans.”

Rosemarie can still clearly picture the moment of her diagnosis. “I was sitting in Dr. Bhutani’s office with my husband. Dr. Bhutani told us I had advanced-stage multiple myeloma.” Rosemarie also remembers her response. “I said to Dr. Bhutani, ‘I have three kids. They need me. I cannot let this beat me.’”

Multiple myeloma is a kind of cancer in blood plasma. In a healthy body, plasma cells (a type of white blood cell) produce antibodies that fight illnesses such as flu, COVID-19, and bacterial infections.

However, “For people with multiple myeloma,” says hematologist/oncologist Ran Reshef, MD, who would become a key partner in Rosemarie’s care, “one or more of their plasma cells mutate and begin to reproduce themselves uncontrollably.” These cancerous plasma cells can quickly accumulate and crowd out healthy blood cells in the bone marrow, Dr. Reshef explains. “They also start to produce abnormal antibodies, basically a protein, that can circulate at high levels and cause problems throughout the body.”

Initial treatment: bone marrow transplant

Dr. Bhutani put Rosemarie on steroids and an oral chemotherapy to stabilize the disease. Then, after additional testing, Dr. Bhutani recommended a bone marrow transplant. “We basically clean out a patient’s bone marrow with a course of chemotherapy, and then we infuse blood stem cells into the patient to repopulate the bone marrow,” Dr. Bhutani explains.

For many patients with multiple myeloma, this procedure can lead to a long-lasting remission. For Rosemarie, however, it did not. “Unfortunately, because the disease was advanced and aggressive, I relapsed after about nine months.” But Rosemarie didn’t give up hope.

Neither did Dr. Bhutani. As Rosemarie recalls, “Dr. Bhutani is a quiet guy, but he’s been a big part of my journey. He made himself readily available and accessible, even outside of business hours, to speak with me and help me navigate my concerns.”

Dr. Bhutani was aware of a multi-center clinical trial of an exciting new therapy, CAR-T cell therapy, which had shown promise as a treatment for various blood cancers. The trial was being run by his colleague, Dr. Reshef, and there was a good chance Rosemarie could participate.

CAR-T cell therapy

The name of the therapy suggests how it works. ‘CAR’ stands for chimeric antigen receptor, and ‘T cell’ is a type of white blood cell. CAR-T cell therapy modifies a patient’s T cells to recognize and destroy cancer cells. According to Dr. Reshef, “CAR-T cell therapy is truly revolutionary. By genetically modifying T cells to express a certain receptor, we can transform a patient’s T cells into serial killers of cancer cells.”

According to Rosemarie, “Drs. Reshef and Bhutani were amazing advocates for me. With their help, and with the encouragement of my husband, I enrolled in a clinical trial.”

The procedure, which took two to three weeks, entailed harvesting Rosemarie’s T cells with a blood draw, modifying their genes to be better cancer killers, culturing the altered T cells so they replicated, and then infusing hundreds of millions of the altered T cells back into Rosemarie.

“It’s important for people to understand,” adds Rosemarie, “that there are many preparatory steps, such as biopsies, blood draws, neurological testing, and imaging scans. Also, there are several months of aftercare and follow up.”

The therapy proved to be effective. “I responded very well,” says Rosemarie. “For about three years, I felt like myself again. More energy, and much less pain. It made a big difference!”

A second course

Rosemarie’s remission meant a dramatic improvement in her daily life, but it did not last. “Multiple myeloma is a sneaky disease,” she says. “You think you have it under control, and then it starts to resist the treatment. Or the disease will attack a different part of the body. It’s a chronic condition that requires a lot of maintenance therapy.”

In July of 2024, Rosemarie had her second course of CAR-T cell therapy at Columbia. By then, a highly effective version of CAR-T had been approved by the FDA. As Rosemarie recalls, “I had been through a tough year. So, when Dr. Bhutani and Dr. Reshef recommended a second course of CAR-T cell therapy, I was grateful.”

The second course was successful, and Rosemarie’s myeloma went into remission again to the point where it was no longer detectable anywhere in her body.

“Now, I’m feeling good,” says Rosemarie. “The team at Columbia has been terrific. They have helped me in so many ways, and I can’t thank them enough. Multiple myeloma is not an easy thing. The different therapies, the side effects, the stays in the hospital: It’s a lot.”

A patient’s superpowers

When reflecting on her journey, Rosemarie credits her strength and endurance to her husband and the love of her children. “My family is my everything. My husband works nights, yet he still made sure the kids got to their sports and then met me at the hospital each day, staying overnight so I didn’t have to sleep alone. He never skipped a beat.”

Rosemarie also credits her own attitude. “I always treated my diagnosis as a ‘to-do,’” she says. “I didn’t want people to treat me differently because I was sick. And I didn’t want people to treat my kids differently because I was sick.”

Rosemarie also takes the time to support others. “I follow a couple of multiple myeloma Facebook groups, not to post things, but to see if I can be helpful to someone. When I see someone in a similar situation, I’ll reach out privately and tell them three things: First, find a specialist. Second, stay positive. And third, never give up.”