What Are the Risks of CAR T-Cell Therapy?
- The biggest problems with CAR T-cell therapy are low blood cell counts, infection, and bleeding
- Some people develop flu-like symptoms such as fever, chills, and body aches
- Side effects can be severe enough to require a hospital stay in some cases
"CAR T-cell therapy is a very serious therapy and it does have some potentially serious side effects," Dr. Julie Vose, medical oncologist at University of Nebraska Medical Center, tells SurvivorNet.
Read MoreCytokine Release Syndrome
When you receive an infusion of your genetically modified T-cells, those cells will begin to attack the cancer. They also release signaling chemicals called cytokines that help to orchestrate your body's immune response. In normal amounts, cytokines are helpful. But a rush of them can cause inflammation throughout your body, producing a number of symptoms."Inflammation is good if it helps us to fight the lymphoma cells, but unfortunately inflammation is not specific. So it also causes inflammation of all the tissues and organs in the body," Dr. Vose says.
A few days after you get the infusion of T cells, you may develop symptoms that feel similar to a case of the flu: a fever, chills, body aches, vomiting, or diarrhea. Some people develop more severe side effects, such as low blood pressure, shortness of breath, and a rapid heart rate.
Let your medical team know right away if you have any of these symptoms. Your doctor has treatments to bring down your fever and control other symptoms.
Neurotoxicity
The "neuro" in "neurotoxicity" relates to the nervous system your brain and spinal cord. This very serious side effect happens when the infused cells get into your brain and spinal fluid. "That’s a good thing if the lymphoma’s there because it helps to fight the lymphoma, but it’s also a bad thing in that it can cause fluid retention or swelling of the brain," Dr. Vose says.
Signs that the treatment has affected your nervous system include:
- Confusion
- Trouble speaking or understanding language
- Less awareness of the world around you (delirium)
Could You Develop Side Effects?
There is a good chance you'll have one of these side effects after CAR T-cell therapy, considering that more than three-quarters of people on this treatment have at least one symptom. Which side effects you have can vary based on the type of CAR T-cells you get, Dr. Vose says.
Doctors assign CAR T-cell therapy side effects a "grade" based on their intensity. Most side effects are relatively mild what doctors label grade one or two. The higher grades three and four are "more worrisome," Dr. Vose adds. If you do have more severe symptoms, you might need to be treated in a hospital to get them under control.
Receiving CAR T-cell therapy at a reputable cancer center will ensure that if you do have side effects, your treatment team will know how to manage them. "This 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," Dr. Vose tells SurvivorNet.
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