What to know about CAR T-Cell Therapy

Once a patient is referred to the University of Michigan Rogel Cancer Center, they will be evaluated to see if they are eligible for the CAR T-cell treatment. This could involve a series of exams and tests, including blood tests, a bone marrow aspirate / biopsy, spinal tap (for leukemia patients), X-rays, and other scans.

Next, a patient’s T-cells will be removed through a blood draw process called apheresis, in which the T-cells are “siphoned” from the blood stream over a two to three-hour period. The process only removes a small fraction of your T-cells, leaving the remainder of your immune system intact. Once collected, the T-cells are then manufactured into the final CAR-T product through a two to four-week process, in which your T-cells are genetically modified – or “trained” – to target your cancer cells.

The final CAR T-cell product is small, typically less than an ounce in volume. The CAR T-cells are given to patients by intravenous infusion, the infusion lasting less than 10 minutes. Once the CAR T-cells are in the patient’s body, they begin to multiply and attack the cancer cells they have been programmed to destroy. On the average, patients will be admitted to the hospital for two to four weeks following the CAR T-cell infusion, so that the medical team can closely monitor for CAR T-cell side effects during this period. One major side effect of CAR T-cells is the potential development of a condition called ‘cytokine release syndrome (CRS)’, in which the immune system is “revved up” to target the tumor cells. CRS is commonly associated with fevers, shakes, chills, and fluid retention, all signs that the immune system has been activated to attack the cancer cells. CRS typically develops within the first 1-2 weeks after the CAR T-cell infusion, with symptoms ranging from mild to severe (even life threatening) in some patients. The medical team will monitor patients closely during this period, with special treatment required for severe forms of CRS given, if it occurs.

Once a patient has been discharged, they will need to stay within a 60-mile radius of the University of Michigan for up to 8 weeks (after the infusion) so that our clinicians can continue to monitor them closely and respond quickly to any side effects.

Are you a candidate for CAR T-cell therapy?

If you are an adult with relapsed large B-cell lymphomas or under age 25 with B-cell acute lymphoblastic leukemia (ALL) please talk with your oncologist or call 734-647-8902.

Cost

This procedure is generally covered by insurance. The University of Michigan Rogel Cancer Center has resources in place to help you navigate this process.