CAR T-cell Therapy for Leukemia

CAR T-cell therapy is a new form of treatment that unleashes the immune system against cancer cells. It eradicates cancer using the patient’s own immune cells, or T-cells. Through CAR T-cell therapy, patients have achieved long remissions and even cures.

At this time, CAR T-cell therapy is only licensed for use in children and young adults with ALL. However, older leukemia patients may still be able to receive CAR T-cell therapy at Siteman through clinical trials. If your care team believes that CAR T-cell therapy could help you, they will explore enrolling you in a trial.

Siteman Cancer Center was one of the first cancer centers in the United States authorized to perform CAR T-cell therapy. Our oncologists are some of the most experienced practitioners of this technique that you can find.

Learn more about CAR T-cell therapy.

How does CAR T-cell therapy work?

T-cells are a type of lymphocyte, or white blood cell. They play an important role in the immune system. Their job is to detect and destroy invading pathogens as well as abnormal cells.

In patients with leukemia, however, the T-cells fail to recognize that the malignant blast cells circulating in their bloodstream are harmful. They permit the blast cells to multiply and spread.

CAR T-cell therapy corrects this problem. It genetically engineers your T-cells so that they produce a small molecule called a “chimeric antigen receptor,” or CAR. The CAR can stick to the surface of cancer cells, allowing the T-cells to destroy them.

What is it like to undergo CAR T-cell therapy?

There are three main steps to CAR T-cell therapy: T-cell collection, modification, and T-cell infusion.

During T-cell collection, the patient is connected to a special machine that filters the T-cells from their bloodstream. This procedure is called pheresis. It is not painful and usually takes several hours. During pheresis, patients are monitored by specially-trained nurses who keep them comfortable and manage any side effects that might arise. The side effects are usually minor, and may include nausea and dizziness. Most patients tolerate pheresis very well.

Once the T-cells have been collected from the patient, they are sent to a laboratory for modification with the chimeric antigen receptor. It may take several weeks before the new CAR T-cells are returned to Siteman Cancer Center.

When the CAR T-cells are ready, you will be admitted to the hospital for the infusion. The cells will flow into your body through an IV, a process that only takes a short amount of time.

After receiving the T-cells, you will remain in the hospital for a few weeks while the T-cells get to work and your body adjusts. Your care team will monitor you carefully for any side effects, and they will ensure that you are safe to go home before discharging you.

What are the side effects of CAR T-cell therapy?

CAR T-cell therapy often causes a condition called cytokine release syndrome. This happens as the new T-cells stimulate the immune system, which produces an inflammatory response. Symptoms may include high fevers, dangerous fluctuations in blood pressure, and, in some cases, organ failure.

The Washington University oncologists at Siteman are very good at treating cytokine release syndrome. They will use medications to reverse any symptoms that arise. Most patients who develop cytokine release syndrome make a full recovery.