Cancer: CAR T-cell Therapy

If your healthcare provider has suggested you try chimeric antigen receptor (CAR) T-cell therapy for your cancer treatment, you might be wondering what it is. You’re not alone if you’re unfamiliar with this unique approach to cancer care.

CAR T-cell therapy is a type of immunotherapy. A chimeric antigen receptor is made in a lab and added to your body’s T cells (a type of white blood cell). This helps your body recognize and kill cancer cells.

This method has many benefits. For instance, it may work when other methods have failed. But in some cases it can cause serious side effects. Read on to learn more.

How CAR T-cell therapy works

CAR T-cell therapy can take a few weeks and involves:

• Collecting T cells from your body. To do this, a healthcare provider will put 2 IV (intravenous) tubes into your veins. The first IV will draw your blood into a device that separates and collects your white blood cells. The other IV returns the remaining blood to your body. This process is called leukapheresis. It takes several hours.

• Engineering the CAR T cells. Once the white blood cells are removed from your body, your healthcare team separates the T cells. They add the chimeric antigen receptor to the T cells in a lab and wait for these cells to multiply. The CAR T cells for your therapy are designed for the type of cancer you have.

• Chemotherapy (chemo). A few days before the infusion of CAR T cells, you may receive a dose of chemo. This lowers the number of other immune cells in your body. As a result, the new CAR T cells have a better chance of getting activated.

• CAR T-cell infusion. The CAR T cells will be returned to your body. This process is similar to a blood transfusion.

What kinds of cancer does CAR T-cell therapy work for?

So far, CAR T-cell therapy can be used for certain types of lymphoma, leukemia, and multiple myeloma. It is often used after other treatments have been tried. Researchers are studying how CAR T-cell therapy can be used to treat other types of cancer.

Side effects of CAR T-cell therapy

CAR T-cell therapy can cause side effects. Some can be serious. But your healthcare team will take safety measures to help prevent them and watch you closely after treatment.

Side effects can include:

• Allergic reaction

• Low blood levels of potassium, sodium, or phosphorus

• Low blood cell counts, which can put you at risk for bleeding, infection, and bruising

• Nervous system problems:

  • Seizures

  • Headache

  • Anxiety

  • Severe tiredness fatigue)

  • Confusion

  • Hallucinations

• Cytokine release syndrome:

  • Fever

  • Fatigue

  • Low blood pressure

  • Dizziness

  • Chills

  • Liver problems

  • Blood clots

  • Faster heart rate

  • Muscle aches

Talk to your healthcare team about side effects you could have and what you should watch for. Ask when you need to report side effects to your healthcare team.

Working with your healthcare provider

Make sure to talk with your healthcare provider about the benefits and risks of CAR T-cell therapy.

Talk with your healthcare team about what signs to look for and when to call them. Know what number to call with questions. Is there a different number for evenings, weekends, and holidays?

It may be helpful to keep a diary of your side effects. Write down physical, mental, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.