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Why Would Someone Need to Have CAR T-cell Therapy?

A person who is experiencing a relapse of lymphoma or leukemia and other types of blood cancer can opt for this therapy. The therapy is best for blood cancers, while the research for treating other cancers is currently underway.

Thus, in case the other treatment options have been unsuccessful or you have faced relapse of a blood cancer type, this can be the answer.

How does CAR-T Cell Therapy Work?

Now, what this therapy does is fool the cancer cells (that have taken over the immune cells) already in the patient’s body.

Think of cancer as the body’s cells turning into its worst nightmare. Cancer cells are normal cells that have become cancerous due to mutations or uncontrolled cell division. So, when these traitor cells overwhelm the immune system, the primary cancer-fighting immune cell - T-cells becomes weak.

This leads to a weakened immune response by the system against cancer, making T cells ineffective. By now, the patient may already have received a diagnosis from their doctor and may have started the usual course of anti-cancer therapy.

These include medications or radiation whose dose can be quite high, depending on the type and stage of cancer.

For example, the initial stage of cancer may not require a dose of drug that’s significantly harmful for the already weak immune system. However, a later stage of cancer will require a higher dose of medications and radiation therapy, which further damages the healthy cells.

Thus, CAR T-cell therapy acts as the final treatment option when everything else has provided unsatisfactory results.

This is when a novel therapy such as CAR T-cell therapy is employed.

Overview

India is quickly becoming the benchmark for availing advanced therapies such as CAR-T cell therapy and is one of the top destinations to avail world-class treatment at relatively lower costs. Think 60% lower rates than countries such as the US, Turkey, Thailand, and similar others.

The following section looks at the different conditions that CAR-T therapy treats.

Conditions That CAR T Cell Can Treat Include

B-cell acute lymphoblastic leukemia (ALL)
Diffuse large B-cell lymphoma (DLBCL)
Multiple myeloma
Mantle cell lymphoma
Primary mediastinal large B-cell lymphoma

Requirements & Procedure: CAR T Cell Therapy

Here are the requirements and procedure of CAR-T therapy:

Requirements

A suitable candidate for CAR-T cell therapy is someone who matches the following criteria:

Type of cancer - There’s only a small percentage of cancers that CAR-T therapy can take care of - one of those is blood cancers. CAR-T cell therapy is unsuitable for solid tumors.
Treatment history - Patients usually need to have previously failed or relapsed standard treatments for CAR-T cell therapy consideration.
Patient health - Overall health of the person should be relatively good to withstand the rigorous CAR-T cell therapy.
Support system - You must have a caregiver during the T-cell extraction and for the first month post-infusion. In addition, the patient and the support must stay close to the treatment center for some time after the infusion.
Clinical trials - The eligibility criteria to participate in clinical trials vary depending on the trial and its protocol. In addition, some trial protocols require you to have a caregiver.

Procedure

The procedure includes the following steps:

The first step is the WBC extraction through leukapheresis. A machine draws out blood while simultaneously separating the WBC.
Then, the extracted cells are taken to a facility that can help transform them into CAR-T cells. The process takes 3-6 weeks.
You may be put on radiation therapy or chemotherapy after leukapheresis and before CAR-T cell infusion. This is important to manage blood cancer while CAR-T cells grow in enough quantity to treat your condition.
During infusion, you’ll receive lymphodepleting chemotherapy, which reduces the chances of CAR-T cell rejection.

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Benefits and Risk

Benefits

Effectively eliminates cancer by specifically targetting those cells
Lowest risk of allergic reaction due to the use of patient’s T cells
Benefits last for many years (with proper monitoring and recovery) as the living drug can attack cancer cells even if there is a relapse.
Successful even in the most aggressive cases of blood cancer

Proper monitoring is essential in cases when you want to establish complete remission and proper effects of the therapy.

Risks

As with any major treatment, you can expect to experience the following risks:

There may be mild neurological issues such as confusion, seizures, difficulty understanding and/or speaking, loss of balance, and hallucinations.
Cytokine release syndrome, which is an expected reaction that occurs when large amounts of cytokines, which are the signalling molecules, are released.
Weakened immune system, which can increase the risk of infections.
Risk of secondary cancers such as T-cell lymphomas
Blood disorders such as low platelet count, anemia, allergic reactions

If you experience any of these symptoms, it is best to inform your doctor and medical team. Be sure to consult with them before making any treatment decisions.

Potential Side Effects of CAR-T cell Therapy

Just as every treatment has some side effect, which may or may not show up, the therapy has its own set of possible side effects as well.

Cytokine Release Syndrome: A side effect of CAR-T cell multiplication within the system is the release of chemicals called cytokines in the blood. This chemical ramps up the immune system, which can cause serious side effects such as:

i. High fever or chills

ii. Trouble breathing

iii. Headaches

iv. Muscle or joint pain

v. Severe nausea, diarrhea or vomiting

Nervous system issues: The treatment can sometimes cause serious side effects on the nervous system, which is also known as ICANS. Immune effector cell-associated neurotoxicity syndrome shows up in the following ways:

i. Changes in consciousness

ii. Headaches

iii. Confusion or agitation

iv. Seizures

v. Shaking or twitching

vi. Loss of balance

vii. Difficulty understanding and speaking

To avoid any mishap after the procedure, doctors recommend against driving, heavy lifting, and other similar activities for at least several weeks.

There are other potential side effects of this treatment, which include-

Allergic reactions during infusion
Low blood cell count
Weakened immune system
Abnormal mineral levels in the blood
Increased risk of getting another type of blood cancer

If you experience any of the above signs and symptoms, it is important to immediately inform your doctor or the concerned healthcare team.

Recovery

Ensuring proper recovery is key to prolonging the positive effects of this therapy. Here are a few ways you can get it right:

Adhering to the recovery plan recommended by your doctor. For example, staying at the hospital for 7-10 days.
Having a caregiver at all times till at least 1-1.5 months after the therapy. This helps with proper monitoring.
Maintaining a proper diet as recommended by the doctor.
Showing up for every follow-up appointment is helpful in keeping an eye on the remission.

Stay in touch with your doctor and medical team for complete monitoring. This will also help you avoid severe reactions.

Why choose Yapita Health for CAR T-cell Therapy

As a companion in your medical journey, we ensure you get the best on-ground support apart from world-class CAR-T cell therapy at the top hospitals in India.

Get in touch with us today to improve your health outcomes!

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