If your child has acute lymphoblastic leukemia (ALL) that has come back or stopped responding to treatment, they may be eligible to receive chimeric antigen receptor (CAR) T cell therapy. This revolutionary new immunotherapy boosts the power of the immune system to attack cancer cells. The power behind CAR T cell therapy is the body’s own T cells. They normally fight viruses and bacteria, and are one of the body’s strongest lines of defense. During CAR T cell therapy, we modify some of your child’s own T cells to recognize and kill leukemia cells. The treatment is like a living drug because the modified T cells can remain in the body for months and possibly years, protecting your child against cancer.
MSK is one of the most experienced centers in the world in the use of CAR T cell therapy. We’ve prepared this information so you can learn more about CAR T cell therapy, how it works, and what to expect if your child receives this treatment. The US Food and Drug Administration has approved the use of CAR T cell therapy to treat children and young adults up to age 25 with recurrent, persistent B-cell acute lymphoblastic leukemia. If you want to know more about this treatment and find out if your child might be able to receive it, call 888-MSK-CART (888-675-2278) to speak with a member of our CAR T cell therapy staff. If your child is a possible candidate, we’ll make an appointment to see one of our doctors as soon as possible. MSK Kids is committed to finding the best treatment for your child and achieving the best outcomes.
How does CAR T cell therapy work?
Some of your child’s T cells are collected from their blood. In a laboratory, scientists insert a gene into the T cells that enables them to make the CAR protein. The transformed T cells are multiplied and then given back to your child, where they can now recognize and kill cancer cells.
Who will care for my child during CAR T cell therapy?
MSK has a multidisciplinary team at the ready for you and your family. Our team has been treating patients with CAR T cell therapy since the inception of this breakthrough treatment. Your child’s CAR T care team includes specialists in bone marrow transplantation, neurology, and intensive care, and nurses with specialized training in caring for children and young adults being treated with CAR T cell therapy.
What can we expect during CAR T cell therapy?
If we think your child may be able to receive this treatment, we’ll request their medical records and make an appointment for you to consult with one of our doctors. If we can move forward after the consultation, we’ll schedule the collection of T cells from your child. This process is called leukapheresis. Most children will need a specialized catheter (tube) placed before T cell collection. We’ll ensure that your child is relaxed and comfortable during every step of this procedure.
We’ll send your child’s T cells to a lab so they can be genetically modified to become CAR T cells. It takes 20 to 30 days for the CAR T cells to be returned to us to give back to your child. Before this happens, we will give your child a cycle of conditioning chemotherapy. This reduces the amount of leukemia in the body and improves the ability of CAR T cells to work. Two to 14 days after this chemotherapy is finished, we will give the CAR T cells back to your child through an IV. This takes about 30 minutes and causes minimal side effects during or immediately afterward.
Does my child have to stay in the hospital for CAR T cell therapy?
Conditioning chemotherapy and the infusion of CAR T cells can sometimes be done on an outpatient basis, but some patients need to stay in the hospital. It depends on the severity of your child’s leukemia and their overall health and response to the treatment. After receiving the infusion of CAR T cells, some patients need up to 30 days of inpatient monitoring to manage any side effects, but others need less time. We will let you know where your child can receive treatment and what to expect.
Does CAR T cell therapy cause side effects?
The CAR T cell therapy experts on the MSK Kids team are some of the most experienced specialists in the world. We are dedicated to monitoring and managing any side effects your child may experience. Many children and young adults treated with CAR T cell therapy at MSK Kids have had minimal side effects and achieved a good response to the therapy. Some patients do have stronger side effects than others, ranging from flulike symptoms (such as fever, rapid heart rate, low blood pressure, low oxygen level, or difficulty breathing) to effects on kidney and nervous system function. Our CAR T cell team will speak with you about the possible side effects and how we handle them. We do all we can to ensure that your child is safe and comfortable during this therapy.
If I come from far away to get CAR T cell therapy for my child, can I get travel guidance and other help?
Families come to us from across the country and around the world for our care, and MSK Kids staff members are available to help them make plans. We can help arrange for local housing and transportation to get to MSK, among other resources. Our CAR T cell therapy team can connect you with the MSK professionals who can assist with these matters.
What kind of care will my child need after CAR T cell therapy?
We will monitor your child’s blood and bone marrow for up to 15 years to look for evidence of cancer and see if the CAR T cells are working. The first five years will include blood tests to make sure your child remains cancer free. The next ten years will include regular check-ins to make sure they remain healthy.
Will my insurance company or the government pay for my child’s CAR T cell therapy?
Our CAR T cell program coordinators will connect you with one of our trained financial advisers to answer any questions you may have about paying for treatment.