CAR-T cell therapy has been one of the most significant advances in cancer treatment for many years, successfully treating patients with leukaemia when other treatment options have failed. University College Hospital in London is one of the few centres internationally to offer CAR-T cell therapy for teenage and young adult patients with blood cancer.
A personalized living drug targeting cancer cells
T-cells are part of our natural immune system, working in a targeted way to attack specific invaders in the human body. In CAR-T cell therapy, T-cells are harvested from a patient and sent away for genetic modification, so they recognise, seek out, and destroy their own specific cancer cells, leaving the healthy cells alone. It is like producing a personalised living drug which targets proteins on the surface of leukaemia cells.
CAR-T cell therapy is a highly effective, novel therapy for under 25s with B-acute lymphoblastic leukaemia (B-ALL). It is most frequently used in patients with relapsed disease but can be used earlier if the leukaemia is not responding to chemotherapy. It can also be used in some sub-types of aggressive lymphoma.
Highly specialized environment and expertise for optimal patient care
The treatment has several stages. The initial T-cell harvesting process takes four to six hours with few side effects. T-cells are then sent to a drug manufacturer where they are modified to accurately target the cancer cells.
During this time (three to six weeks), patients are given a gentle cycle of chemotherapy, usually as an outpatient, to keep their leukaemia controlled with as few side effects as possible. Patients are monitored to check whether it is an appropriate time to be given CAR-T therapy, and then admitted to hospital for two to four weeks where they are given a course of chemotherapy followed by an infusion of modified cells.
As patients are at an elevated risk of infection, cytokine release syndrome, or the unique neurological side effects of CAR-T, it is vital they remain in a highly specialised environment where staff are experts in both recognising these symptoms and treating similar patients. University College Hospital has a world-leading adolescent cancer centre with access to an onsite intensive care unit. It has some of the best international expertise in treating teenage and young adult cancer patients; the only dedicated London centre to do so.
Patients are monitored carefully for around three months after treatment. Tests during this time include bone marrow and blood tests to check for progress. Initially they will stay as an inpatient, but if it looks like the disease has responded to treatment they can be discharged and seen as an outpatient after 28 days. The team is experienced in managing any side effects and patients are carefully monitored after treatment in case issues arise.
Holistic approach: Addressing psychological well-being and cultural support
Patient care at University College Hospital is delivered in an age-appropriate way by expert consultants (including those on the UK CAR-T advisory panel), nurse specialists, and other allied health professionals. Patients are looked after holistically, including their psychological wellbeing, which is extremely high priority.
For Arabic patients, a team of advocates is on hand to support patients, families and healthcare professionals navigate their way through both treatment and settling into the UK. Patients are also able to enjoy day-rooms, a gym, and relaxation rooms which have been designed in collaboration with adolescent patients, helping them to feel comfortable and at home.
Follow-up care and monitoring for sustained remission
Follow-up care is usually managed via phone or video consultations from the patient’s home country during month four and five, and a return visit in month six is required to check all is well.
For more information:
- www.uclhprivatehealthcare.co.uk
- uclh.ipo@nhs.net
- (+44) 020 3448 4260
