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CAR T-cell immunotherapy
Some young people with acute lymphoblastic leukaemia (ALL) may be offered a special type of immunotherapy called CAR (chimeric antigen receptor) T-cell therapy.
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Overview
T-cells are part of the immune system and their job is to hunt down and attack abnormal cells in the body. CAR T-cell immunotherapy modifies a person’s own T-cells so they are better able to do this.
First, a small plastic tube (cannula) is inserted into a vein in each arm. Blood is taken from one arm and fed through a special machine that separates out the T-cells. The remaining blood is then returned to you through the cannula in the other arm.
Chimeric antigen receptor is added to the T-cells to make them into CAR T-cells. This happens in a laboratory and may take 2–3 weeks. The CAR T-cells are then injected back into your body to attack the leukaemia cells.
Currently, this treatment is only funded through the Medicare Benefits Schedule for some young people (aged 25 or younger) with a certain type of ALL. If you are suitable for CAR T-cell therapy, you may be referred to a specialist centre for treatment.
Side effects of CAR T-cell immunotherapy
These may include:
- a high temperature
- fast heart rate
- low blood pressure and dizziness
- nausea and/or vomiting (feeling and/ or being sick)
- muscle and joint pain
- breathing difficulties.
These side effects usually occur in the first 10 days after treatment and can be managed, but it’s important to let your doctor know about them.
In the 4–8 weeks after treatment, there may also be side effects in the brain, including headaches, loss of balance and confusion. These brain-related side effects usually get better in 1–2 weeks and can be managed.
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Dr Jonathan Sillar, Haematologist, Calvary Mater Newcastle Hospital; Dr Scott Dunkley, Haematologist, Royal Prince Alfred Hospital and Chris O’Brien Lifehouse; Sharon Frazer, Consumer; Dr Robin Gasiorowski, Staff Specialist, Haematology, Concord Hospital; Prof Angela Hong, Radiation Oncologist, Chris O’Brien Lifehouse, and Clinical Professor, The University of Sydney; Yvonne King, 13 11 20 Consultant, Cancer Council NSW; Heather Mackay, Clinical Nurse Consultant – Haematology, Westmead Hospital; Katelin Mayer, Clinical Nurse Consultant, Cancer Outreach Team, Nelune Comprehensive Cancer Centre.
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