Lurie Children’s Center for Cancer and Blood Disorders offers a cutting-edge immunotherapy called chimeric antigen receptor (CAR) T-cell therapy, which uses the patient’s own immune system to fight cancer.
CAR T-cell therapy is FDA approved to treat children and adolescents with B-acute lymphoblastic leukemia (B-ALL) that is resistant to chemotherapy or that has relapsed multiple times. Patients also might be eligible for CAR T-cell therapy after the first relapse of B-ALL if they are not able to undergo a stem cell transplant.
Patients with B-ALL who have detectable disease at the end of their consolidation phase of chemotherapy, relapsed and/or refractory B-cell non-Hodgkin lymphoma, and relapsed or refractory ependymoma may be candidates for CAR T-cell therapy through participating in clinical trials at Lurie Children’s.
Lurie Children’s was an early adopter of this breakthrough treatment that provides a lifesaving option if chemotherapy fails. We have developed considerable expertise with CAR T-cell therapy, using a multidisciplinary approach to care for our patients. We also are actively involved with multiple consortia that work on advancing CAR T-cell therapy applications in pediatrics.
How CAR T-cell Therapy Works
The immune system contains a type of white blood cells called T-cells. During CAR T-cell therapy, the patient’s T-cells are taken from the blood, genetically modified to improve their ability to fight cancer, grown to large numbers, and then reintroduced back into the bloodstream where they are better able to recognize and destroy cancer cells.
First, the patient’s white blood cells are removed from a blood sample and sent to a laboratory.
The T-cells are then separated from the other white blood cells and a CAR gene is added to the T-cells. The modified CAR T-cells can detect and eliminate cancer cells.
Growing millions of CAR T-cells needed to fight cancer can take a few weeks in the laboratory. In the meantime, the patient may receive what is known as “bridging chemotherapy.”
Once the CAR T-cells are ready, the infusion is scheduled. As preparation, the patient is given a brief course of chemotherapy called “lymphodepleting chemotherapy.”
During the infusion, the CAR T-cells are returned to the patient in one dose.
The CAR T-cells then start to multiply and destroy cancer cells. The CAR T-cells can remain in the body for months, or even years, helping to prevent recurrence of cancer.
After CAR T-cell Therapy
Following the CAR T-cell infusion, we monitor closely for ongoing CAR T-cell activity and for any minimal residual disease through a monitoring schedule. This strategy allows us to identify if there has been a loss of CAR T-cell activity so that we can intervene to prevent the return of cancer.
If you’d like to request an appointment with one of our specialists, call 1.800.543.7362 (1.800.KIDS DOC®) or visit our Appointments page for more information.