CAR T-Cell Therapy
CAR T therapy is a revolutionary type of blood cancer treatment that programs a patient’s own altered white blood cells to kill cancer cells. Advanced technology is used to separate white blood cells (an essential part of your immune system) from the rest of your blood cells. The white blood cells are then sent to a specialized laboratory, where they are engineered to produce specific chimeric antigen receptors (CARs) on their surface. Before returning these cells to the patient, they are multiplied in a laboratory in order to obtain millions of modified cells.
These CAR T-cells are then injected back into your bloodstream. Now, the new CARs can help the modified cells latch on to the coordinating antigen on tumor cells – effectively hunting down and killing cancerous cells.
When other blood cancer treatments fail, CAR T-cell therapy has worked, putting some people’s cancers into remission. A significant benefit of CAR T-cell therapy is that it not only instructs the T-cell to kill cancer, but it also triggers the T cell to grow and divide. Therefore, after just one CAR T-cell treatment, the cells remain in your body and continue to attack the tumor for months or even years.
CAR T-cell therapy is highly specialized and personalized, and it is available at a limited number of cancer centers around the world. At Sheba Medical Center in Israel, our oncologists have trained at premier medical institutions and we are pleased to offer this breakthrough therapy. Our physicians provide CAR T-cell therapy with a customized and holistic approach that pays attention to your unique needs and the overall well-being of your whole body.
Diseases Treated by CAR T-Cell Therapy
At Sheba, we offer therapy for the following types of cancer:
- Acute Lymphocytic Leukemia (ALL), Adult
- Non-Hodgkin Lymphoma (NHL), Adult and Child
- Leukemia (ALL), Child
- Multiple Myeloma
- Acute Myelogenous Leukemia (AML)
Side Effects of CAR T-Cell Therapy
In general, most patients who receive CAR T-cell therapy do not experience the typical side effects that are associated with chemotherapy, such as nausea, vomiting, and hair loss. However, there are risks of other serious side effects. Because CAR T-cell therapy is given as a one-time infusion (and not in sessions, like chemotherapy), most of the possible complications occur within the first one to two weeks after treatment. They are usually temporary and can be resolved with medication. It is extremely important to communicate with your medical team at Sheba, so our skilled doctors can help to alleviate and manage your side effects.
The most common side effects include:
- Cytokine release syndrome, which involves symptoms that resemble the flu – high fever, chills, low blood pressure, muscle or joint pain, shortness of breath, and a fast heart rate. These symptoms can range from mild to severe.
- Neurologic difficulties, such as confusion, tiredness, seizures, agitation, aphasia (difficulty with speech or understanding), encephalopathy (brain malfunction, disease, injury), and loss of balance.
- Anemia (low red blood cell count)
- Neutropenia (low white blood cell count)
How is CAR T-Cell Therapy Given?
Your medical team at Sheba will design your customized CAR T-cell therapy to target your specific type of cancer. We are committed to clear and open communication with every patient, so there is no confusion and you always know what to expect. The following outline is a step-by-step explanation of how CAR T-cell therapy is given.
- Testing for Candidacy: We will perform various tests and screenings to evaluate whether CAR T-cell therapy is a suitable treatment for you.
- T-Cell Collection: By using a special machine for apheresis, T cells will be separated from the rest of your blood cells.
- Cell Engineering: Your T-cells will be sent to a lab where they are genetically modified to produce CARs on their surface. CARs are proteins that enable the T-cells to identify particular antigens on the surface of tumor cells.
- Growing T-cells: The specially altered T-cells are grown in our on-site Sheba laboratory until there are millions of them; this process can take a few weeks.
- Chemotherapy: Before we infuse the CAR T-cells into your body, we may give you chemotherapy treatments to kill additional cancer cells, which creates more space for the CAR T-cells to proliferate in your body.
- Infusing T-cells: Shortly after chemo, you will be hospitalized so that we can re-infuse the CAR T-cells into your body. This process is performed in a similar manner to a blood transfusion.
- Recovery: While you will only receive a one-time infusion, you may need to stay in the hospital for a few weeks so our doctors can monitor your condition closely and manage any side effects, as needed. Typically, it takes about two to three months to recover.
- Follow-up: Your Sheba doctors will instruct you about how frequently you must return over the next few months for periodic follow-up appointments. We will evaluate your overall health thoroughly, checking your body’s response to the therapy. Over the next several years, you will return for blood tests, physical examinations, and/or bone marrow biopsies and PET or CT scans.
Patient Testimonial – After CAR T-Cell Therapy
“Like a bolt from the blue…” That was Sam Turel’s reaction when first diagnosed with chronic lymphoproliferative disease. Sam had enjoyed an active full life, but when he heard the words “blood cancer,” he fell into acute despair. After years of initial treatments slowed him down, he was later diagnosed with chronic lymphocytic leukemia (CLL). It was time to seek an advanced treatment method, and Sam chose Sheba for CAR-T cell therapy.