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What is the difference between chemotherapy and immunotherapy, and which one is best for me?
Ibrahim Aldoss
September 8, 2025
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For World ALL Day 2025, Know ALL spoke to Ibrahim Aldoss, City of Hope Comprehensive Cancer Center, Duarte, US. We asked, What is the difference between chemotherapy and immunotherapy, and which one is best for me?
During this interview, Dr Aldoss explained the key differences between chemotherapy and immunotherapy in the treatment of acute lymphoblastic leukemia (ALL). Dr Aldoss explained that chemotherapy is a standard part of ALL treatment, particularly for children and young adults. Chemotherapy works by targeting cells that divide quickly, such as leukemia cells but also some healthy cells. Because of this, chemotherapy can cause side effects such as low blood cell counts, fatigue, nausea, and hair loss.
Immunotherapy works in a different way, helping the body’s own immune system to recognize and destroy leukemia cells, especially those that carry a protein called CD19.One example of an immunotherapy is the bispecific antibody blinatumomab, which links leukemia cells to T cells, causing the immune system to attack the cancer. Another approach, chimeric antigen receptor (CAR) T-cell therapy, involves collecting and genetically modifying a patient’s own T cells so they can better recognize and kill leukemia cells when they are returned to the body. Both of these types of immunotherapy can be highly effective but may cause side effects such as cytokine release syndrome, which can result in fever or low blood pressure, and neurological symptoms such as headaches, confusion, or tremors.
Dr Aldoss emphasized that you do not necessarily need to choose between chemotherapy and immunotherapy, they can complement eachother at different stages of care. Additional therapies, such as antibody–drug conjugates like inotuzumab ozogamicin, are also available for certain patients with relapsed or refractory disease. Dr Aldoss concluded by encouraging patients to discuss with their care team whether immunotherapy may have a role in their treatment plan, how it is given, and what side effects to expect.
