Our immune system is a protective system that patrols inside the body and monitors various substances inside the body. If the immune system recognizes any substance which does not belong to the body and maybe harmful, the system activates itself and attack that substance. The cells of the immune system work through a complex mechanism. It protects from various diseases, including infection and cancer. However, in some cases of cancer, the immune cells are unable to recognize the cancer cells and thus, do not destroy them. It is when the doctor uses CAR T-cell therapy. It is a type of immunotherapy and has various advantages over conventional therapy. It has fewer side effects and offers more precise treatment.
The CAR T-cell therapy is completed in different steps. A highly experienced team comprises hematologists, oncologists, pediatricians, and paramedical staff. The steps for performing CAR T-cell therapy are:
1. T-cell collection: In this process, the doctor collects the T-cells from the blood. This procedure is known as leukapheresis. The doctor performs this procedure with the help of a machine. The machine has two IV lines. The blood flows through one IV line into the machine and returns through the second IV line after removing the T-cells or white cells. The procedure may take around 2-3 hours.
2. Genetic Engineering: The staff sends the T-cells to the laboratories where they undergo genetic engineering process for adding the Chimeric Antigen Receptor (CAR) on the cell surface. This protein on the cell surface helps the T-cell to identify the cancer cells.
3. Cellular Multiplication: A large number of T-cells are required to be injected into the body. Thus, the genetically engineered T-cells undergo a multiplications process in the laboratory. This may take a few weeks to complete the process.
4. Lymphodepleting chemotherapy: This step is also known as conditioning. During this process, the patient receives chemotherapy. This reduces the number of other cells of the immune system to allow the space for proliferating the CAR T-cells. The patient undergoes conditioning a few days before the infusion of CAR T-cell.
5. CAR T-cell infusion: Approximately 3 days after the chemotherapy, the doctor infuses the CAR T-cells in the bloodstream. It may take around 10 to 30 minutes for infusion.
After the infusion, the patient must stay in the hospital for a few weeks. The doctor monitors the efficacy of CAR T-cell therapy and its side effects. Even after the discharge, there are chances that the patient may be re-admitted due to complications. The patient should visit the hospital for a follow-up that may last for months. During the long-term recovery, the patient may have tests, such as blood tests, physical examination, and imaging tests.
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