When you learn that you have cancer, you feel a lot of fear and anxiety. But with the advancement of medical science, today there are very advanced treatment methods to fight cancer. Today, we are going to talk about a new and very powerful treatment method that has been very successful in treating several types of cancer , especially those that develop in the blood.
What is CAR T-Cell Therapy?
Simply put, CAR T-Cell Therapy is an immunotherapy used to treat certain types of blood cancers . Our own immune cells are like soldiers in our bodies. What this treatment does is take some of these soldiers in your own body, called T cells ( T cells or T lymphocytes ) , and turn them into super fighters that destroy cancer cells.
Imagine taking your T cells to a lab , inserting a new gene into them, and giving them a “special lens” that can recognize cancer cells. We call these modified T cells CAR T-cells . `CAR` stands for `Chimeric Antigen Receptor`. Then, millions of these super-fighter cells are made and put back into your body. These cells then travel throughout your body, seeking out and destroying cancer cells. Sometimes, this treatment can even cure blood cancers completely.
What types of cancer is this treatment used for?
Currently, CAR T-Cell Therapy is only used for certain types of blood cancers where other treatments have failed or where the cancer has come back. The table below lists some of these types of cancers.
| Cancer Type | A brief introduction |
|---|---|
| B-cell acute lymphoblastic leukemia (ALL) | Acute lymphoblastic leukemia that arises from B-cells. |
| Diffuse large B-cell lymphoma | A type of lymphoma that grows rapidly. |
| Follicular lymphoma | A type of slow-growing lymphoma. |
| Mantle cell lymphoma | A generally rare, but aggressive type of lymphoma. |
| Multiple myeloma | A bone marrow cancer that arises in plasma cells. |
| Primary mediastinal large B-cell lymphoma | A type of lymphoma that occurs in the middle part of the chest. |
Okay, now let's see how this works.
To understand this, let's first learn a little more about the T cells in our immune system. Every cell in our body has proteins called antigens on its surface. These are like an ID card that every cell has. Cancer cells have an altered, abnormal ID card.
Our T cells have receptors . These receptors are what recognize invaders like cancer cells that have unusual ID cards (antigens). But sometimes cancer cells are very cunning. They hide from these T cells.
This is where we need the help of CAR T-cells. These are your own T cells that have been specially trained in the lab and modified to recognize a specific antigen on cancer cells .
This treatment allows these cells to not only kill cancer cells, but also to divide and multiply within the body. This means that you get a long-term supply of cancer-fighting cells. This is why doctors call this treatment a “living drug.”
How does the treatment process work?
This entire process takes place in several stages.
Before treatment
First, you need to collect white blood cells, especially T cells, from your body. This is called leukapheresis.This is a process similar to donating blood. A machine takes some of your blood, separates out only the white blood cells, and then returns the rest of the blood to your body.
These collected T cells are then sent to a specialized laboratory to be turned into CAR T-cells. This process can take about 3 to 6 weeks. During this time, you may be given other treatments, such as chemotherapy, to control the cancer.
When you are ready to receive CAR T-cells, you will be given a treatment called lymphodepleting chemotherapy to prevent your body from rejecting the new cells.
During treatment
The actual treatment is very simple. Just like giving saline, these newly created CAR T-cells are infused into your body through a vein (IV line) over a period of 5 to 30 minutes. During this time, you will need to stay in the hospital.
After treatment
Because this is a very powerful treatment, sometimes serious side effects can occur. Therefore, you may have to stay in the hospital for about 7-10 days after the treatment. It is very important to stay within easy reach of the hospital where you received treatment for the first month, even after you leave the hospital. Also,
- Someone should be with you 24 hours a day to take care of you if you have any side effects.
- Don't drive for two months after treatment. You need someone else to do that.
What are the side effects of this treatment?
There are two types of side effects that are most common and worth paying attention to with this treatment. Other common side effects may also occur.
| Type of side effect | Visible features |
|---|---|
| Cytokine Release Syndrome | Fever, difficulty breathing (dyspnea), low blood pressure. (This can be serious) |
| Neurological Issues | Confusion, difficulty speaking (aphasia), difficulty writing (dysgraphia), headaches, seizures, tremors. |
| Other | During treatment, there is a risk of allergies, fatigue, bleeding, increased risk of infection, and low potassium (hypokalemia) and sodium (hyponatremia) levels. |
What are the benefits and success rates of this treatment?
The biggest advantage of CAR T-Cell Therapy is that it offers new hope to patients who have failed other treatments. Sometimes it can completely cure the cancer (remission). Otherwise, this treatment can extend the life of patients.
For example, a 2020 study showed that more than 85% of children who received this treatment for acute lymphoblastic leukemia (ALL) were completely cured after treatment. Also, 60% of them were still cancer-free after a year. But it is important to remember that this is not a 100% successful treatment for everyone, a cure for everyone. However, this is a major step forward in the field of cancer treatment.
When should you see a doctor?
This is very important. Some of the side effects of CAR T-Cell Therapy, especially Cytokine Release Syndrome and nervous system problems, can be life-threatening .
So before you leave the hospital, be sure to ask your doctor what symptoms you should be especially concerned about. If symptoms such as fever, chills, headache , and nausea persist, call your doctor immediately, or go to the hospital's Emergency Department (ETU).
This treatment is still a new field that is still developing. So if you have blood cancer, talk to your doctor about whether this treatment is right for you.
Take-Home Message
- CAR T-Cell Therapy is a highly potent and personalized immunotherapy treatment used for certain types of blood cancers .
- This involves modifying your own T-cells in a lab and then re-injecting them into your body to kill cancer cells.
- This treatment acts as a “living drug,” fighting cancer long-term in the body.
- Serious after treatmentClose medical supervision is essential as side effects may occur. Any suspicious symptoms should be reported to the doctor immediately.
- While this offers new hope for patients who have failed other treatments, only your doctor can decide if it is right for you.
CAR T-Cell Therapy, cancer treatment, blood cancer, immunotherapy, immune therapy, T cells, Sri Lanka
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