CAR T-Cell Therapy for Leukemia
Leukemia is a relatively common cancer that originates in blood-forming tissues, primarily the bone marrow and lymphatic system. The cancer interferes with the production of healthy blood cells, causing an overproduction of abnormal white blood cells that diminish the body’s ability to control bleeding and fight off infection. Leukemia may be treated with a combination of therapies, such as chemotherapy, radiation therapy, bone marrow transplantation and immunotherapy.
An emerging treatment option for leukemia, immunotherapy is a complex and highly personalized therapy that capitalizes on the power of the body’s own immune cells to target and destroy cancerous cells. CAR T-cell therapy is an advanced type of immunotherapy that involves modifying a patient’s own white blood cells (T-cells) in a laboratory. Specifically, the patient’s T-cells are genetically re-engineered to express chimeric antigen receptors (CARs). When the altered T-cells are reinfused to the patient, the CARs will bind to certain proteins found on the surface of leukemia cells, such as CD19, helping the patient’s immune system find and destroy the cancerous cells.
What does CAR T-cell therapy for leukemia involve?
A type of adoptive cell transfer immunotherapy, CAR T-cell therapy for leukemia involves several steps:
- T-cell collection – After blood is drawn from the patient, the T-cells in the blood will be separated from the other blood components through a process known as leukapheresis.
- T-cell genetic modification – In a specialized lab, the collected T-cells will be genetically modified to express CARs on their surface.
- CAR T-cell expansion – The modified T-cells will be cultured and expanded in the lab to create a large quantity of CAR T-cells.
- Conditioning therapy – Before the modified T-cells are infused into the patient’s bloodstream, the patient may undergo a short course of chemotherapy to reduce the number of other immune cells in their body and create a more favorable environment for the CAR T-cells.
- CAR T-cell infusion – The re-engineered CAR T-cells will be infused into the patient's bloodstream through a procedure similar to a blood transfusion.
- CAR T-cell response – Once in the bloodstream, the CAR T-cells will circulate throughout the body to seek out and bind to leukemia cells, initiating a potent immune response that can destroy the cancerous cells.
- Monitoring – After CAR T-cell infusion, the patient will be closely monitored for side effects and response to treatment.
In essence, CAR T-cell therapy can help the body’s immune system become a better cancer fighter.
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Request an AppointmentWhat are the risks and possible complications of CAR T-cell therapy for leukemia?
CAR T-cell therapy for leukemia, while promising, carries several risks and potential complications, including:
- Cytokine release syndrome (CRS) – The infused CAR T-cells may release large amounts of signaling proteins that help control inflammation (cytokines), which can lead to high fever, low blood pressure, difficulty breathing and organ dysfunction.
- Neurotoxicity – The immune response to CAR T-cell therapy may affect the central nervous system, causing symptoms ranging from mild confusion and headaches to difficulty speaking, difficulty walking and seizures.
- Infection – As the immune system works hard to fight the cancer, the body may be temporarily susceptible to other types of infection.
- Blood disorders – CAR T-cell therapy can cause short-lived blood changes that may lead to anemia (low red blood cell count), thrombocytopenia (low platelet count) and other blood disorders.
These potential complications necessitate careful monitoring and management by the healthcare team during and after the treatment to ensure patient safety and address any adverse effects promptly.
What to expect during recovery from CAR T-cell therapy for leukemia
After CAR T-cell therapy for leukemia, the patient may experience fatigue, fever and other flu-like symptoms. During regular follow-up visits, the healthcare team will assess the patient’s response to treatment, help them manage any side effects and monitor for complications, such as CRS and neurotoxicity, which are common in the initial weeks after infusion. Most patients gradually resume their normal activities. Long-term monitoring will be essential to evaluate the effectiveness of CAR T-cell therapy for leukemia and check for signs of relapse or late-onset side effects.
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Schedule an AppointmentHow effective is CAR T-cell therapy for leukemia?
CAR T-cell therapy has shown effectiveness for certain types of leukemia, particularly relapsed or refractory acute lymphoblastic leukemia (ALL) and some cases of chronic lymphocytic leukemia (CLL). Clinical trials and real-world applications have demonstrated high rates of remission, with some patients achieving long-term cancer-free survival.
While CAR T-cell therapy offers a new source of hope to patients with leukemia that has not responded to traditional treatments, researchers continue to explore ways to optimize its efficacy and manage the associated side effects.
Benefit from world-class care at Moffitt Cancer Center
Over the last several years, Moffitt has been leading an important initiative in collaboration with cancer centers across the nation to develop and refine cancer immunotherapies. CAR T-cell therapy in particular can be a game-changer for certain patients who are fighting leukemia, especially those who have not benefitted from traditional treatments.
If you would like to learn more about CAR T-cell therapy for leukemia, you can request an appointment with a specialist in our Malignant Hematology Program by calling 1-888-663-3488 or submitting a new patient registration form online.