Summary: CAR T-cell therapy is a new treatment option for patients with acute lymphoblastic leukemia, some lymphomas, and multiple myeloma that have not responded to prior therapies. This presentation describes how CAR T cell therapy works, its risks and side effects, and how these may be effectively managed.

This presentation was made possible, in part, by Kite, a Gilead Company.

Presenter: Michael Tees MD, MPH, Colorado Blood Cancer Institute, part of the Sarah Cannon Cancer Institute at Presbyterian/St. Luke’s Medical Center

Meet the speaker: https://faculty.mdanderson.org/profil...

To read the transcript, go to: https://www.bmtinfonet.org/video/2022...

Highlights:

CAR T cell therapy involves removing some of a patient’s T-cells and engineering them to recognize particular cancer cells. These enhanced T-cells are then returned to the patient’s body where they can attack cancer cells.
CAR T therapy can cause cytokine release syndrome leading to fever, lower blood pressure, and shortness of breath. The likelihood of this side effect is high, but its severity varies a lot. There are several treatments for this problem.
CAR T-cell therapy can also cause neurotoxicity or ICANS. The likelihood, severity and symptoms of neurological problems vary with the underlying disease. Neurotoxicity is almost always reversible.

May 3, 2022 Part of the Virtual Celebrating a Second Chance at Life Symposium 2022
Presentation is 39 minutes long with 20 minutes of Q & A.

Key Points:

(07:50): CAR-T cell therapy is currently approved for B-cell acute lymphoblastic leukemia, some lymphomas and multiple myeloma if other treatments have failed.

(09:46): Acute myeloid leukemia, myelofibrosis and some solid tumors are not yet good candidates for CAR T therapy.

(13:23): The correct T-cells must be selected for conversion to CAR T-cells in order to be effective.

(13:42): Viruses are used to insert genetic material into T-cells and convert them to CAR T-cells.

(15:38): Patients with aggressive disease may require bridging therapy to control their disease while CAR T-cells are being created.

(17:41): The major side effects between Day 0 and 28 are infection, cytokine release syndrome and neurotoxicity.

(27:46): After CAR T-cell therapy, “chemo brain” or “brain fog” can affect concentration and short term memory.

(29:45): Low blood counts and ongoing risk of infection are possible late effects of CAR T-cell therapy.

(32:33): Patients do not respond well to the COVID vaccine after CAR T-cell therapy, so precautions against COVID, like wearing a mask for a year, are important.

(33:39): Anti-viral therapy is recommended after CAR T-cell therapy to reduce the risk of shingles.


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