September 9, 2020
This Treatment Involves a Multi-Step Process
- In clinical trials, CAR T-cell therapy has demonstrated efficacy for certain hematological malignancies
- Lymphocyte collection and CAR T-cell generation involves a 17- to 21-day process
- Patients are observed carefully after treatment for cytokine release syndrome, encephalopathy, and other adverse effects
Chimeric antigen receptor (CAR) T-cell therapy has been transformative in blood cancer therapy, particularly for patients with previously poor outcomes; however, producing the CAR T-cells can be a complex process. “CAR T is novel, it is exciting, but it is also overwhelming for the patients,” says Dr. Siddhartha Ganguly, deputy director of hematologic malignancies and cellular therapeutics at the University of Kansas School of Medicine.
He talked SurvivorNet Connect through the multi-step process needed to collect the lymphocytes, generate the CAR T, and infuse patients with the re-engineered cells. The process takes about 17 to 21 days, depending on the type of CAR T-cells being generated. Once the cells are ready, patients start on lymphodepletion therapy, which consists of three days of chemotherapy followed by two days of rest, to prepare their body to accept the CAR T.
Dr. Ganguly says all of his CAR T patients are admitted to the cellular therapeutics unit, where they remain for seven to 10 days. They receive the CAR T, and are then observed very carefully for cytokine release syndrome and encephalopathy.
Patients who do well are discharged from the hospital. They are seen every day for the first couple of weeks, and then gradually tapered down to evaluations every other day. After 30 days, following a disease status examination that may include a PET scan or a CT scan, patients are allowed to go back to their own oncologists. However, they continue to be monitored frequently at a CAR T center to “make sure that the disease continues to respond,” Dr. Ganguly adds.