The Risks Associated with CAR T-Cell Therapy
- CAR T-cell is an intense therapy that can have serious side effects
- Most patients need to be on antibiotics and get transfusions during treatment
- The side effects that most concern doctors are Cytokine release syndrome, which can cause high fevers and low blood pressure; and neurologic toxicity, in which the cells migrate into the spinal fluid and into the brain
“CAR T-cell therapy is a very serious therapy and does have some potentially serious side effects,” Dr. Julie Vose, chair of the hematology and oncology department at the University of Nebraska Medical Center’s Buffett Cancer Center, explains to SurvivorNet.Read More
The TreatmentCAR T-Cell therapy essentially wipes out a patient’s existing immune system and replaces it with an immune system genetically modified to fight cancer cells.
The RisksThe potential side effects include:
- Low blood counts
Those that concern doctors more, says Dr. Vose, are:
- Cytokine release syndrome, which can cause high fevers, aches in the bones or muscles, and low blood pressure
- Neurologic toxicity, in which the cells migrate into the spinal fluid and into the brain
In terms of neurologic toxicity, Dr. Vose explains that T cells entering the spinal fluid or the brain is theoretically good in that the lymphoma cells that need attacking are located in these areas. However, the patient can end up with swelling and inflammation in their brain.
“That’s why [the therapy] has to be given in centers that know how to give it, have participated in the trials, and have very extensive experience in taking care of these types of patients,” says Dr. Vose.
How Common Are These Side Effects?
“There are several different types of Car T cells and some have a little bit more of these side effects than others,” says Dr. Vose. “Almost all patients get a very low amount of [these side effects] and it’s easy to treat with the therapy we have.”
However, “it’s the more serious higher grades, grade 3 and 4, of these neurotoxicity and cytokine release syndrome [side effects] that are more worrisome,” she says. In those cases, they can affect “a very low percent, maybe like 2% of patients, up to as high as 30% or 40% of patients, depending on the specific construct that’s used.”