South African phase 1 trial tests donor-line NK cells in relapsed B-cell lymphoma

A phase 1 trial in South Africa is testing engineered natural killer (NK) cells, grown from an established laboratory cell line, in patients with relapsed or treatment-resistant B-cell non-Hodgkin lymphoma. The study, QUILT-106, involves a team led at Wits Donald Gordon Medical Center by haematologist Dr Jackie Thomson. Early experience shows mixed results: some patients did not respond, while others reached remission quickly.

A ready-made alternative to autologous CAR-T

Conventional CAR-T therapy is autologous. A patient's own T cells are collected, genetically modified, expanded and returned, so every dose requires its own manufacturing run. The NK cells in QUILT-106 come from a single cell line. They are made abroad and imported for the South African study, so no cells need to be harvested from individual patients.

The cells carry a chimeric antigen receptor directed at CD19, a protein present on certain B cells. Investigators are giving them alone and in combination with rituximab, an antibody that targets a different B-cell protein, CD20.

What the trial can and cannot show

As a phase 1 study, QUILT-106 is designed mainly to assess safety and tolerability, with a secondary look for early signs of activity. It cannot yet say which patients are most likely to benefit, or whether remissions last. Thomson stresses that further research and longer follow-up are needed on both questions.

She expects the approach to be cheaper eventually because it simplifies logistics. That is her expectation rather than a trial result. Real costs will depend on the final price of the product and on the cost of delivering it in clinical practice.

Why the setting matters

The need is considerable. South Africa's National Cancer Registry recorded 2,342 new cases in its non-Hodgkin lymphoma category and 1,428 leukaemia cases in 2024. These figures count diagnoses, not everyone living with the diseases.

Cellular therapies depend on services that can assess patients, handle cell products correctly and monitor recovery. Thomson set up the centre's transplant unit in 2019. In 2025 the Wits Donald Gordon Cellular and Immunotherapy Center gained accreditation from JACIE, an international body that reviews clinical and laboratory practice in stem cell transplantation and cellular therapy. As Thomson puts it, "You need infrastructure to improve the results."

Training alongside research

The unit also trains doctors. Residents rotate through it, and a qualified specialist was completing a fellowship at the time of the interview. Supervised ward rounds and weekly academic meetings give trainees a structured way to discuss treatment decisions.

Trainees learn to interpret bone marrow findings, choose donors and plan transplants. They also learn to judge whether enough viable stem cells have been collected and how they are stored. Teaching continues into recovery, when blood counts and immune reconstitution must be tracked and complications recognised.

Transplantation remains relevant even as newer therapies arrive. Donor immune cells can help eradicate residual cancer but may also attack healthy tissue, causing graft-versus-host disease, so clinicians must weigh the benefits against the risks. Thomson is clear that cell therapies have not made transplants unnecessary.

Capacity and what comes next

A 2025 paper in the South African Medical Journal, from the BloodSA Cell and Gene Therapy working party, named training in transplantation and cell and gene therapy as a priority. It also called for specialised facilities and funding for staff. Thomson adds a further concern: trained doctors often struggle to find funded posts. Wider access, in her view, needs positions for these skills to be used, together with reliable diagnostics and timely referral.

For the research itself, the next steps are completing the phase 1 assessment of safety, collecting longer-term data on durability of response and late complications, and clarifying which patients benefit. Those results will determine whether an imported, line-derived product can become a practical option in settings where individualised manufacture is hard to deliver.

Source: South African trial tests off-the-shelf killer cells against lymphoma (Medical Xpress, 7 November 2026).

Image: AI-generated illustration.