COVID-19 Risks
- CAR T-cell therapy is a treatment that re-engineers your immune cells to make them better cancer fighters.
- The treatment starts with chemotherapy, which can wipe out much of your existing immune system and leave you more vulnerable to infection with COVID-19.
- You and your doctors will take extra precautions to prevent you from getting sick during your treatment.
But the process of harvesting your immune cells and preparing your body to receive the newly modified cells can temporarily leave you more vulnerable to COVID-19 infection. People who’ve had CAR T-cell therapy are at higher risk for serious COVID complications. They’re more likely to need treatment in a hospital, and they’re at higher risk of dying from the infection.
Read MoreHow CAR T-Cell Therapy Works
The process of CAR T-cell therapy starts when your doctor draws your blood and separates out your T cells. These are the white blood cells that help your immune system protect your body from infection.Related: CAR T-Cell Therapy: How it Works, and Who Can Get It
CAR T-cell therapy is known as an “immune-activating therapy.” “They’re really trying to take advantage of the patient’s own immune system,” explains Dr. Thomas Martin, a hematologist-oncologist at the University of California San Francisco (UCSF) who specializes in multiple myeloma and other blood cancers.
The cells are sent out to a facility, where they’re re-engineered to produce special protein receptorscalled chimeric antigen receptors (CARs)on their surface. These new receptors will help the cells find and attach to a matching protein on the surface of cancer cells.
After the modified cells are multiplied into the millions, creating a cancer-fighting army, they’re infused back into your body. But before that happens, you’ll get chemotherapy for about three days to clear out some of your damaged immune cells and prepare your body to receive the new ones.
Losing those immune cells will leave your immune system weakened and less able to fight infections, which could pose a problem if you’re exposed to COVID-19. “We’re making that patient very immunocompromised,” Dr. Martin explains. “And that immunosuppression lasts six months or a year.”
How Worried Should You Be?
COVID-19 should be on your mind if you’re having CAR T-cell therapy, but it shouldn’t stop you from having this treatment if your doctor says you need it, Dr. Martin says. It can be helpful to go over your concerns with your oncologist before you start treatment. “If you have a question about whether your therapy is very immunosuppressive, then you can just ask your doctor,” he says.
You do need to be careful to prevent COVID-19, but the precautions you’ll take are similar to the ones you should already be taking. “Follow the same rules as they’ve been following for the last year. And that is social distancing. Wearing a mask. Staying away from people,” Dr. Martin says. “I wouldn’t host any gatherings.”
Highly effective vaccines are now available against COVID-19, and the American Society of Hematology (ASH) recommends that anyone who is going to have CAR T-cell therapy get vaccinated as soon as possible.
Your medical team will also take precautions. They will wear protective equipment such as gloves, masks and gowns whenever they care for you. They should also check you regularly for COVID-19 symptoms, and test you for COVID-19 while you’re in the process of receiving this treatment.
Your medical team may also try to limit your in-person visits to reduce your possible exposure to the virus. After your treatment, you may get special medicines that stimulate your bone marrow to produce more infection-fighting white blood cells, to build your immunity back up more quickly.
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