Chimeric antigen receptor T-cell (CAR-T) therapy

CAR-T cell therapy—also known as CAR-T therapy—is a groundbreaking form of immunotherapy that uses your own T-cells to target and destroy cancer cells. In this process your T-cells are collected, reprogrammed in a lab to recognize cancer, and then returned to your body through an infusion.

This personalized treatment is typically used when other therapies haven't worked, offering new hope for patients with certain relapsed or treatment-resistant blood cancers.

Some CAR-T therapies have been approved by the U.S. Food and Drug Administration. Others are being studied in clinical trials.

1. T-Cell collection: Your T-cells are collected from your bloodstream in a process called apheresis. This is similar to donating platelets or plasma and usually takes a few hours in a clinic.
2. Making your CAR-T cells: Your T-cells are sent to a specialized lab where they are treated with gene therapy. Scientists reprogram your T-cells to make special proteins called chimeric antigen receptors (CARs). which help them find and destroy cancer cells. These CAR-T cells are grown in the lab for 2 to 6 weeks, creating millions of cancer-fighting cells. During this time, you’llbe at home or receiving other treatments.
3. Chemotherapy: 3–5 days before you get your CAR-T cells, you’ll receive chemotherapy infusions to prepare your body. The chemotherapy removes your regular T-cells to make room for the new CAR-T cells.
4. Receiving your CAR-T cells: You’ll be in a hospital or clinic the day of your CAR-T cell infusion. The infusion takes about an hour. You’ll be closely monitored by your care team for several hours afterwards. If doctors think you’re doing well enough, you’ll go home.
5. Recovery: CAR-T cell treatment isn’t over after the infusion. Most people need bone marrow biopsies over the next few weeks to monitor how the treatment is working. You may even get more infusions of CAR-T cells, and doctors will continue to monitor your health for up to 15 years.

Symptoms may include:

• Fever
• Headache
• Hypotension (low blood pressure)
• Hypoxia (low oxygen levels)
• Increased heart rate
• Joint pain
• Muscle aches/pains
• Rapid breathing
• Rash
• Severe fatigue

CRS can appear at any time within the first few weeks after CAR-T therapy and can range from mild to life-threatening, but is often manageable with prompt care.

CAR-T therapy can impact the brain and nervous system. These symptoms can range from mild confusion to more serious neurological issues.

Symptoms include:

• Confusion or forgetfulness
• Difficulty speaking or walking
• Difficulty swallowing
• Drowsiness or low energy
• Seizures (in rare cases)
• Tremors

If you or your caregiver notice changes in your speech, coordination or alertness, tell your medical team right away.

Some patients experience other symptoms during or after CAR-T therapy, including:

• Allergic reactions
• Low blood counts
• Nausea or loss of appetite
• Temporary kidney or liver problems
• Increased risk of infection

Your care team will monitor your bloodwork and organ function regularly to catch any issues early before they cause long term damage.

Right now, CAR-T cell therapy is not an option for people who've been newly diagnosed with blood cancer. This type of cell therapy is primarily for people whose blood cancer returned or didn't respond to standard treatments like chemotherapy or a blood stem cell transplant.