What Is CAR T-cell Therapy?

T-cell therapy is a type of immunotherapy in which the patient’s immune cells are modified in a laboratory to attack cancer cells. There are two types of T-cell therapy – tumour-infiltrating lymphocytes therapy and CAR T-cell therapy. In a T-cell therapy process, the T-cells are collected from the patient’s blood, and a gene for a special receptor is added to them. The special receptor added is called a Chimeric Antigen Receptor (CAR).

The CAR T-cells grown in the lab are now transferred back into the patient’s body through a vein. T-cell therapy is used in treating certain types of blood cancers like leukaemia in children and lymphoma in adults. It is also called adoptive cell transfer.

Types of Cancers Treated With CAR T-cell Therapy

Apart from its effectiveness in managing leukaemia in children and lymphoma in adults, CAR T-cell therapy is recommended in children and young adults with B cell Acute Lymphoid Leukaemia in the following conditions:

  • Newly diagnosed cases
  • In people whose leukaemia has not gone away despite two cycles of treatment
  • Relapse of treatment more than twice
  • If chemotherapy isn’t sufficient to prevent a relapse

 

In adults, T-cell treatment is recommended if:

  • Relapse of diffuse B cell lymphoma after two treatments
  • Mantle cell lymphoma continues to grow or relapsed after treatment with a targeted drug

 

Only a few centres in the UK offer T-cell therapy in clinical trials. Your doctor may recommend this treatment you believe your cancer may respond to this treatment.

Who Is A Candidate For CAR T-cell Therapy?

Apart from its effectiveness in managing leukaemia in children and lymphoma in adults, CAR T-cell therapy is recommended in children and young adults with B cell Acute Lymphoid Leukaemia in the following conditions:

  • Newly diagnosed cases
  • In people whose leukaemia has not gone away despite two cycles of treatment
  • Relapse of treatment more than twice
  • If chemotherapy isn’t sufficient to prevent a relapse

 

In adults, T-cell treatment is recommended if:

  • Relapse of diffuse B cell lymphoma after two treatments
  • Mantle cell lymphoma continues to grow or relapsed after treatment with a targeted drug

 

Only a few centres in the UK offer T-cell therapy in clinical trials. Your doctor may recommend this treatment you believe your cancer may respond to this treatment.

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CAR T-cell Therapy Procedure

The usual process of T-cell therapy is as follows:

  • T-cell collection

The T-cells are collected from the patient via a special tube called the vascath. One tube is placed on one arm and used to remove blood from the vein. This blood is passed into an apheresis machine. This machine separates blood components and takes out the T-cells while the other components are put back through your other arm. This process can take around four to five hours. The T-cells collected from you are sent to the laboratory for conversion into CAR T-cells and freezing.

  • Chemotherapy

You will have to undergo a chemotherapy procedure before the CAR T-cells are transferred into your body. This process is called lymphodepletion.

  • T-cell transfer

The CAR T-cells are defrosted once you are ready for your T-cell transfer. You will be given anti-allergens to prevent any allergic reactions that may occur with a T-cell transfer. This procedure takes around 30 minutes.

  • Monitoring

Once your T-cell transfer is complete, you will be monitored by your healthcare team for around two weeks. A hospital stay may be needed, or you will have to report to the hospital every day.

Benefits of Using CAR T-cell Therapy In Cancer Treatment

T-cell therapy has some benefits over other cancer treatments:

  • Shorter treatment time
  • Rapid recovery as the treatment is not as aggressive as chemotherapy
  • Prolongs remission and reduces the chances of cancer recurrence in some patients
  • Long-lasting effects that prevent a relapse

Side Effects of CAR T-cell Therapy

Though CAR T-cell therapy effectively treats some challenging cancers, it may cause severe or sometimes life-threatening side effects. One of the most likely effects of CAR T-cell therapy is Cytokine Release Syndrome (CRS). Some serious side effects that can arise from this condition include:

  • An allergic reaction
  • Fever with chills
  • Difficulty in breathing
  • Headaches
  • Nausea
  • Vomiting
  • Feeling dizzy or lightheaded
  • Rapid heartbeat
  • Tiredness
  • Muscle or joint pain

 

Some people may experience nervous system side effects such as:

  • Confusion
  • Agitation
  • Seizures
  • Twitching or tremors
  •  Loss of balance

 

If you have been advised to get T-cell therapy, speak to your doctor about the possible side effects you are likely to experience as it helps you prepare in advance.

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T-cell therapy is usually offered under clinical trials. If you wish to undergo T-cell therapy or need a second opinion about your cancer treatment options, speak to your doctor about it. Need help finding a second opinion? Connect with us today!

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