We know how challenging it is to fight cancer. It's normal to feel overwhelmed when doctors say new, complex words like "gene therapy." But don't worry. Today we're going to talk about one such specific treatment. Imagine using your own body's cells, training them, and sending them to destroy cancer cells. That's what this treatment called Tisagenlecleucel does. Let's talk about it simply and clearly.
What is Tisagenlecleucel (KYMRIAH)?
Simply put, this is not a pill you take or a regular drug you inject into a vein. Tisagenlecleucel is a gene therapy . It involves taking a type of cell from your own immune system, modifying it in a lab, and training it to recognize and attack cancer cells.
To be precise, our bodies have a type of fighter cell called T-cells. These cells are the ones that fight off disease. In this treatment, doctors take some of these T-cells from your body. Then, in a lab, they use genetic technology to put two "special glasses" on these T-cells. That is, they modify these cells so that they can recognize specific markers on the surface of cancer cells. Then, millions of these "superpowered" T-cells are grown and injected back into your body through a vein. Now these trained cells go straight to the cancer cells and destroy them.
This treatment is mainly used to treat several types of cancer, including acute lymphoblastic leukemia (ALL) , a type of leukemia, and non-Hodgkin lymphoma .
Things you need to tell your doctor before starting treatment
Even though this is a treatment using your own cells, it is essential to have a very open conversation with your care team before you begin. They should be made aware of the following:
- Current infections: Tell us if you currently have any infections, such as fever, cough, cold, or urinary tract infection.
- Inflammatory conditions: Tell your doctor about any inflammatory disorders anywhere in the body.
- Allergies: Be sure to mention any allergies you have, not just to this medication, but to any other medication, food, or dye.
- Pregnancy: If you are pregnant, trying to get pregnant, or have any suspicions that you are pregnant, tell your doctor right away. This is very important.
- Breastfeeding: If you are breastfeeding, also inform the doctor.
How do you give this treatment?
This treatment involves several steps and is performed under the close supervision of a medical team in a hospital or specialized clinic.
1. Cell collection: About 3-4 weeks before the treatment, T-cells are collected from your body. This is done through a process called leukapheresis . It is similar to donating blood. Blood is taken from a vein, passed through a special machine, which separates out the white blood cells, including the T-cells, and then the remaining blood is put back into your body.
2. Cell training: These collected cells are then sent to the lab and trained to fight cancer.
3. Infusion: Once the cells have been trained and grown, they are infused into your body through a vein, much like a saline solution. This entire process takes place in the hospital.
The most important thing is that because this medicine is made from your own cells, it is a personalized treatment for you . Therefore, this medicine cannot be shared with anyone else.
Things to consider when undergoing treatment
Your condition will be monitored closely by your doctors during this treatment. You should also be aware of these factors.
- Drowsiness and driving: You may feel drowsy and dizzy . So , do not do anything that requires mental alertness, such as driving or operating heavy machinery, until you know exactly how this medicine affects you.
- Risk of infection: This treatment may temporarily reduce your body's ability to fight off illness. So try to stay away from people who are sick. If you develop symptoms like fever, body aches, or sore throat , call your doctor right away instead of self-medicating.
- Blood or organ donation: Avoid donating blood, organs, tissues, sperm, or eggs (oocytes) while taking this treatment and for a period of time afterward.
- Pregnancy (Very Important): Do not become pregnant for any reason while taking this medication. Also, if you are planning to have a baby or suspect that you are pregnant, you should tell your doctor immediately. This medicine can seriously harm an unborn baby.
- Other medications: Tell your doctor about any other medications you are taking (including vitamins and herbal remedies). Live vaccines are especially not available at this time.
- Emergency: This is given in a hospital setting, so you will not be taking too much medication. However, if an emergency occurs, inform the medical team immediately. If necessary, they will refer you to the Emergency Treatment Unit (ETU) . If you suspect any poisoning, you can call the National Poisons Information Centre at the Colombo National Hospital .
Possible side effects of this medicine
Like all medicines, this one can have side effects. Some of these should be reported immediately, while others are less serious. See the table below.
| Classification of side effects | |
|---|---|
| Things to report to your doctor or medical team immediately | |
| Allergies | Skin rash, itching, swelling of the face, lips or tongue. |
| Breathing difficulties | Difficulty breathing. |
| Mental changes | Confusion, difficulty speaking or understanding. |
| Symptoms of low blood cell count | Symptoms of infection: fever, chills, sore throat. Signs of bleeding: bruising, red spots on the skin, black stools, blood in the urine. Low red blood cell count: extreme fatigue, fainting, paleness. |
| Other serious symptoms | Diarrhea, loss of balance, muscle or joint pain, nausea, vomiting, seizures, symptoms of low blood pressure (dizziness, fainting). |
| If it persists or is bothersome, tell your doctor. | |
| Common side effects | Constipation, loss of appetite, headache, stomach pain, swelling of the legs and feet. |
This list does not include all possible side effects. If you experience anything unusual, talk to your doctor about it.
Take-Home Message
- Tisagenlecleucel is a personalized gene therapy that uses your own immune cells to treat cancer.
- This is a special treatment given in a hospital, used for severe leukemia and lymphoma conditions.
- It is imperative that you tell your doctor all your health information (infections, allergies, pregnancy) before starting treatment.
- During treatment, be especially aware of signs of infection (fever, cough). If such symptoms occur, seek medical advice immediately.
- As you may feel drowsy, avoid driving and doing tasks that require attention until you have fully recovered.
- Avoid pregnancy completely during treatment. This is very important.
- Don't be afraid to talk to your medical team about any concerns or doubts you may have. They are there to help you.
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