One of the youngest adult CAR-T patients ready to return home

Devon Tesler, 20 recently completed a groundbreaking new gene therapy at IU Health Simon Cancer Center.

By IU Health Senior Journalist T.J. Banes

That pesky cough – it was still lingering. But Devon Tesler is feeling better. He’s hopeful.

The 2017 graduate of Hamilton Southeastern High School prepared to return home after completing a new gene therapy under the care of IU Health hematologist/oncologist Dr. Hillary Wu. It’s been a little over a year since Tesler was first diagnosed with Non-Hodgkin lymphoma. It all started with a cough.

He’d been coughing since March and made a couple trips to the doctor. First he was put on antibiotics, then allergy medication. When his physician suggested a chest x-ray, he learned he has lymphoma. He was referred to IU Health where he went through six rounds of chemotherapy followed by several rounds of radiology. He was preparing for a stem cell transplant when his family learned about CAR-T therapy.

The innovative gene therapy uses custom-made cells to attack a patient’s own specific cancer. CAR-T cell therapy allows doctors to isolate T-lymphocyte cells – the body’s cells that fight infections and are active in immune response. The T cells are then engineered to express a chimeric antigen receptor (CAR) that targets a protein on a patient’s cancer cells, attaches to them and eventually kills them. IU Health is one of the first sites in Indiana to administer the treatment. Tesler is one of the youngest adult patients to receive the therapy.

As he prepared to go home Tesler talked about the side effects of the treatment. His appetite has been spotty but he still has a taste for his favorite candy Tootsie Rolls and Twizzlers. He’s slowly building back up from his 10-pound weight loss.

“I haven’t noticed too many side effects other than swelling in my elbows, ankles, and wrists. I also get fevers and headaches,” said Tesler. That pesky cough is one of the few lingering symptoms that he had before treatment. It was one of the first signs that he was ill.

“He did the radiation so the cough started to subside and then it came back after chemo,” said his mom, Michelle Byrd. “Because CAR-T is so new there are no typical symptoms that we should expect. Every patient is different.”

There’s been another surprise too – he hasn’t lost the brown hair on his head, and he has more facial hair than usual.

Aside from his favorite sweets, Tesler has also had a taste for lots of veggies and waffles. He’d also like to visit one of his favorite restaurants Panda Express.

But first things first.

“He can eat what he wants, but no outside food unless it’s prepackaged or frozen,” said his mom. We’ll be staying close to home and keeping an eye on his levels. It’s great to have this kind of care so close to home. Some people come from far away and have to spend the months after CAR-T in a hotel.”