Apheresis: The Blood Draw Process
- A doctor evaluates your veins to see where the IV should be placed.
- You will be hooked up to a machine that filters your blood for a couple of hours.
- Once the T cells are filtered from your bloodstream the blood is returned to your body.
Unlike most other treatments, the first step in this process is removing specific immune cells called T cells from your blood so they can be sent to a laboratory and genetically re-engineered to become more efficient cancer killers. T cells are immune cells that help your body fight off foreign and dangerous invaders, such as cancer. "The process of removing the T cells from your blood is called apheresis," explains Dr. Nina Shah, hematologist and professor of clinical medicine at the University of California San Francisco. "The blood is removed through an IV or catheter so that we can collect the cells that are necessary to be shipped off, so they can be engineered to become CAR T-cells."
Apheresis: Taking Your Blood and Making it BetterRead More
The Next Steps in CAR T-Cell Treatment
Having your blood cells removed and sent to a lab is only the beginning of your CAR T-cell treatment journey. It will take several weeks, though time can vary, for the lab to modify your blood cells and turn them into the CAR T-cell therapy. The cells will be genetically engineered to grow special structures called chimeric antigen receptors (CAR) on their surface. When these new CAR T-cells are returned to your body, the receptors help the cells identify and attack cancer cells anywhere in the body.
During the weeks while you’re waiting for your blood cells to be altered, your doctor might consider giving you what is called "bridging chemotherapy." This is chemotherapy given between the blood draw procedure and the infusion of CAR T-cells. It's meant to control your disease until your T cells are ready. "You may get steroids or chemo that you’ve already gotten before, but only for a few weeks, because we want to make sure that you’re nice and pristine before those T cells come back," explains Dr. Shah.
The altered T cells will be shipped back to the medical center where you'll be receiving the CAR T-cell treatment. Before the new cells are administered, you'll receive three days of chemotherapy to prepare your body. Then you'll receive the Abecma–your altered blood cells–through an IV and return to the medical center to be monitored for side effects and complications for at least a week.
While side effects from this treatment can sometimes be severe, the success rate is impressive and many patients achieve extremely long remissions. In the Phase 2 trial that helped Abecma receive FDA approval, almost three-quarters of the patients had a response to treatment, and almost a third of the patients went into remission.