South African trial tests off-the-shelf killer cells against lymphoma
- Wits University
A Wits team is investigating engineered immune cells while training specialists in the clinical and laboratory work behind complex blood cancer care.
South African researchers are testing “off-the-shelf” immune cells against lymphoma that has returned or resisted treatment, investigating an approach that avoids having to manufacture a separate treatment from each patient’s own cells.
The trial uses genetically engineered natural killer (NK) cells grown from a shared laboratory cell line. Researchers are assessing their safety and looking for evidence that they can help patients with certain B-cell lymphomas.
Dr Jackie Thomson, a clinical haematologist and stem cell transplant specialist at Wits Donald Gordon Medical Centre (WDGMC), combines this research with teaching doctors to deliver complex blood cancer care. The Donald Gordon Medical Institute (DGMI) is the centre’s research and training arm.
Thomson has seen treatment options expand considerably over her career. “We have so many options for these patients. It really doesn’t feel like a death sentence anymore,” she says.
The study involving her team, QUILT-106, focuses on selected B-cell non-Hodgkin lymphomas. Its engineered cells carry a chimeric antigen receptor, or CAR, designed to recognise CD19, a protein found on certain B cells. Researchers are testing the cells alone and with rituximab, an antibody treatment targeting another protein, CD20.
As a phase 1 study, it focuses on safety and tolerability while looking for early evidence of a response. Thomson describes varied outcomes.
“Some patients didn’t respond, and other patients responded incredibly well and they went into remission very quickly.”
Further research and follow-up are needed to establish which patients might benefit and whether responses last.
How the cells are produced is a central distinction. Conventional autologous CAR-T therapy uses a patient’s own T cells, which must be collected, genetically modified and expanded before being returned to that person. Each patient requires an individual manufacturing process.
The NK-cell product used in QUILT-106 comes from an established cell line and is manufactured abroad and imported for the South African study. This avoids having to collect and engineer each patient’s own immune cells.
Thomson sees the potential to simplify logistics and reduce costs. “I think in the long run they will be cheaper,” she says. The trial has not established those savings; affordability will depend on the eventual price and cost of delivering treatment.
The need for blood cancer care is substantial. South Africa’s National Cancer Registry recorded 2,342 new cases in its non-Hodgkin lymphoma category and 1,428 cases of leukaemia in 2024. These are recorded diagnoses, rather than everyone living with these diseases.
Delivering advanced treatments requires services that can assess patients, handle cell products correctly and monitor recovery. Thomson established the transplant unit in 2019. In 2025, the Wits Donald Gordon Cellular and Immunotherapy Centre achieved JACIE accreditation, recognising compliance with international standards.
JACIE (an international certification body for stem cell transplantation and cellular therapy) assesses clinical and laboratory practice and the quality systems supporting them.
“You need infrastructure to improve the results,” Thomson says.
Registrars rotate through the unit, and at the time of the interview the team was training a fellow, an already qualified specialist developing further expertise. Supervised ward rounds and weekly academic meetings allow doctors to work through treatment decisions with experienced clinicians.
“That’s why it’s so important for us to have the registrars rotating through the unit now,” she says.
Trainees learn to interpret bone marrow findings, select donors and plan transplants. They must understand whether enough stem cells have been collected, whether those cells are viable and how they are preserved. The teaching extends through recovery, when complications must be recognised and managed.
The work connects what happens in the laboratory with what happens at the bedside, including monitoring blood counts and immune recovery in the weeks after a transplant.
A transplant can restore blood-cell production after intensive treatment. Donor immune cells may also attack remaining cancer, but can attack healthy tissue too, causing graft-versus-host disease. Specialists must weigh these risks and benefits. Thomson is clear that newer cell therapies have not removed the need for transplantation.
Research requires careful records and sustained follow-up to establish whether responses last and complications emerge. Thomson describes the demands of meeting research standards alongside clinical care and accreditation.
Nationally, a 2025 South African Medical Journal paper from the BloodSA Cell and Gene Therapy working party identifies training in transplantation and cell and gene therapies as a priority, alongside specialised facilities and funding for personnel.
Thomson also worries about what happens after training. She describes doctors struggling to find funded posts despite the need for their expertise. Expanding access requires places to use those skills, supported by diagnostic services and timely referrals.
She would like more time to concentrate on the science itself. “I’ve got a lot of dreams of just spending time with the natural killer cell,” she says. For now, her days also involve teaching doctors and maintaining the clinical and laboratory systems that allow that research to happen.