CAR T-cell therapy side effects in lymphoma patients

When chemotherapy and radiation fail, some adult patients with B-cell non-Hodgkin’s lymphoma or children with acute lymphoblastic leukemia have a new treatment option called CAR T-cell therapy. Yescarta is the CAR T-cell therapy that’s FDA-approved to treat patients with B-cell non-Hodgkin’s lymphoma; it shrinks the tumors in 70-80% of patients. But with this new therapy come side effects that are different from those of other cancer treatments. To better understand these side effects in adult lymphoma patients, we talked with Felipe Samaniego, M.D. How does CAR T-cell therapy work? Like other types of immunotherapy, CAR T-cell therapy uses the patient’s own immune system to treat cancer. T cells – one type of the immune system’s fighter cells – are extracted from the patient, modified in a lab and then transfused back into the patient. During the next four weeks, the modified CAR T cells rapidly multiply in the body, building a robust army that finds and attacks the cancer cells. For about 30 days, patients are also at risk for side effects, some of which can be life-threatening. What are the side effects of CAR T-cell therapy in lymphoma patients? To prepare the body for CAR T-cell therapy, patients receive a small dose of chemotherapy, which may cause other side effects, such as fatigue and low blood count. As the CAR T cells work to fight cancer, they cause the release of large amounts of other T cells into the blood, along with cytokines, which are proteins released by cells that communicate to other cells that there’s a job to be done. This effect triggers the production of even more...