Getting Your Blood Drawn for CAR T-Cell Therapy

The apheresis process is a painless outpatient procedure which will only take a few hours. "It will be done at the center where you decide to go for the CAR T-cell therapy," explains Dr. Shah. Before the day of the procedure you'll have an evaluation by a doctor who will examine your veins to see where the IV can be placed.

Then, the day of the procedure, the IV will be inserted and you'll be hooked up to a special machine for a couple of hours. "Once you're hooked up to that machine, the blood will be pulled out of you and filtered out for the T cells that are necessary for treatment. Then the blood will go back into you," explains Dr. Shah. "You may feel a little bit of fatigue, you may feel some numbness and tingling in your fingers and toes, but you'll be monitored closely throughout and the procedure is generally comfortable."

Although the actual blood draw takes just a couple of hours, from start to finish the entire process takes about half a day. Afterwards, you'll be able to go home, though you'll need someone to drive you in case you received any medications that would make you sleepy or too impaired to drive safely. All in all, says Dr. Shah, "it's a pretty easy outpatient procedure."

The Next Steps in CAR T-Cell Treatment

Having your blood cells removed and sent to a lab is only the beginning of your CAR T-cell treatment journey. It will take several weeks, though time can vary, for the lab to modify your blood cells and turn them into the CAR T-cell therapy. The cells will be genetically engineered to grow special structures called chimeric antigen receptors (CAR) on their surface. When these new CAR T-cells are returned to your body, the receptors help the cells identify and attack cancer cells anywhere in the body.

During the weeks while you’re waiting for your blood cells to be altered, your doctor might consider giving you what is called "bridging chemotherapy." This is chemotherapy given between the blood draw procedure and the infusion of CAR T-cells. It's meant to control your disease until your T cells are ready. "You may get steroids or chemo that you’ve already gotten before, but only for a few weeks, because we want to make sure that you’re nice and pristine before those T cells come back," explains Dr. Shah.

The altered T cells will be shipped back to the medical center where you'll be receiving the CAR T-cell treatment. Before the new cells are administered, you'll receive three days of chemotherapy to prepare your body. Then you'll receive the Abecma–your altered blood cells–through an IV and return to the medical center to be monitored for side effects and complications for at least a week.

While side effects from this treatment can sometimes be severe, the success rate is impressive and many patients achieve extremely long remissions. In the Phase 2 trial that helped Abecma receive FDA approval, almost three-quarters of the patients had a response to treatment, and almost a third of the patients went into remission.

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