Preparing for CAR T-cell therapy is a complex journey that involves active participation from both the patient and the healthcare team. As CAR T-cell therapy continues to grow and evolve in the oncology space, it is crucial to understand what to expect in terms of the treatment process, potential challenges, and the impact on your life.
CAR T-cell therapy must be completed at specialized treatment centers, and you must meet specific requirements in order to gain access to treatment. African Americans are less likely than other ethnic groups to receive CAR T-cell therapy. If you are considering this therapy option, increasing your knowledge of CAR T-cell therapy can help you navigate the process.
Identifying a Caregiver
If you are preparing to receive CAR T-cell therapy, you may be required to designate a caregiver beforehand. Your caregiver should be someone close to you such as a friend or family member. They should be able to commit to being with you full time during the entire therapy process including your time in the hospital and also after discharge as you recover. You may need more than one caregiver. Caregivers can help with daily tasks, managing your medications, coordinating your health care, and advocating for you.
Selecting the right caregiver for CAR T-cell therapy is a critical decision. Your caregiver’s involvement and support can significantly impact your experience and outcome. Open and honest communication with your caregiver is essential to ensure you both are comfortable throughout the treatment process.
What to Expect
Treatment Process
The process of developing CAR T-cell therapy is complex and precise. Understanding the treatment process can help you feel more engaged in your treatment and help you know what to expect. Click here [link back to BHM What is CAR T-cell therapy?] for an overview of CAR T-cell therapy.
Prior to receiving therapy, you’ll consult with the care team at a treatment facility. This visit will include a health assessment and introduction to the health care team. Once approved to receive treatment, your blood will be drawn in order to collect your T cells and create CAR T-cells. This process can take a few weeks.
While you wait, you’ll receive chemotherapy for a few days. This helps to prepare your body for your CAR T-cell infusion by creating an environment where the cells can grow and expand. You’ll have time to rest after chemotherapy and prior to receiving the CAR T-cell infusion.
On the day of the infusion, you will likely spend more time preparing for the infusion than actually receiving it. The infusion itself is a relatively quick process. After the infusion and for the next several weeks, your care team will continue to follow up with you and monitor closely for side effects. Your caregiver will play a key role in side effect monitoring.
Click here to learn more about how you can prepare to receive CAR T-cell therapy.
Potential Side Effect Challenges
Side effect monitoring is a key aspect of receiving CAR T-cell therapy. Side effects can vary from patient to patient but can be serious or life-threatening. Serious side effects your care team will monitor for include:
Cytokine release syndrome (CRS) is one of the most common side effects of therapy and is characterized by symptoms such as fever and chills, trouble breathing, muscle and joint pain, fatigue, and decreased appetite.
Neurotoxicity is another serious side effect that impacts the nervous system and causes confusion, mental state changes, and seizures.
Other side effects to monitor for include infusion reactions, increased infection risk, blood count changes, and lab abnormalities.
Learn more about side effects.
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References
- Transplantation and Cellular Therapy. Socioeconomic and Racial Disparity in Chimeric Antigen Receptor T Cell Therapy Access
- Journal of the Advanced Practitioner in Oncology. Educating Multidisciplinary Care Teams, Patients, and Caregivers on CAR T-Cell Therapy
- Quality of life in caregivers of patients receiving chimeric antigen receptor T-cell therapy
- Biology of Blood and Marrow Transplantation. Building a CAR Garage: Preparing for the delivery of commercial CAR T products at Memorial Sloan Kettering Cancer Center
- American Cancer Society. CAR T-cell Therapy and Its Side Effects
