T-cells are a type of white blood cell that search out and destroy bacteria, viruses,
and other invaders that the immune system does not recognise. Because cancer
cells are the body’s own cells that grow and divide out of control, T-cells may not
recognise them as foreign. CAR-T therapy overcomes this by reprogramming the T-cells to attack cancer cells.
White blood cells form part of the healthy immune system and these include T-cells. CAR T-cell therapy changes some of your body’s T cells, which are collected
from your own blood.
In a laboratory, your T-cells will be reprogrammed to produce special receptors
called chimeric antigen receptors (CARs). When these CARs are placed back into
your body through an intravenous catheter, the receptors should help your T-cells
find and destroy cancer cells.
Although most patients do not experience the common side effects associated
with chemotherapy such as hair loss, nausea, and vomiting, there are risks of
significant side effects with CAR T-cell therapy. Patients are admitted to the hospital
for several weeks so our care team can monitor response to the treatment, and
manage reactions to this therapy. The complications are generally temporary and
resolve with treatment. Our care team is specially trained to identify and manage
these side effects.
Possible side effects from CAR T-cell therapy include:
- Cytokine release syndrome: CAR T-cells can initiate a massive release of substances called cytokines, which triggers an inflammatory condition known as cytokine-release syndrome (CRS). Symptoms may be flu-like, with a high fever and/or chills; low blood pressure; difficulty breathing; or confusion. These symptoms can be mild or severe.
- Neurologic difficulties: Patients may also experience confusion, difficulty understanding language and speaking, or stupor.
Recovery can take time as your immune system recovers. The critical recovery
period is typically for 30 days after the CAR T-cell infusion. During this time, patients must remain within one hour of St James’s Hospital, and must have a caregiver with them at all times to monitor for signs of fever, infection, and neurologic difficulties. Most patients feel tired and don’t have much appetite during this period.
Clinical trials around the world are evaluating CAR T-cell therapy in many different
types of cancer, including multiple myeloma, acute myeloid leukemia, and B-cell
lymphomas. Research is also underway to make CAR T-cell therapy safer and more
effective.