CAR-T Cost in United Arab Emirates

A. CAR-T cost in the United Arab Emirates varies from one hospital to the other. Many hospitals cover the cost of pre-surgical investigations of the patient in the treatment package. The comprehensive CAR-T package cost includes the cost of investigations, surgery, medicines, and consumables. There are many things that may increase the cost of CAR-T in the United Arab Emirates, including prolonged hospital stays and complications after the procedure.

A. Many hospitals across the country offer CAR-T to international patients. The top hospitals for CAR-T in the United Arab Emirates include the following:

1. Kings College Hospital
2. Thumbay Hospital, Ajman

A. The recovery of the patient may vary, depending on several factors. However, on average, a patient is supposed to stay for about 30 days in the country after discharge. During this time, the patient undergoes medical tests and consultations. this is to ensure that the treatment was successful and the patient is safe to return.

A. There are certain additional costs that the patient has to pay apart from the CAR-T cost. The extra charges may start from USD 50 per person.

A. The following are some of the best cities for CAR-T in the United Arab Emirates:

• Abu Dhabi
• Sharjah
• Dubai

A. The average duration of stay at the hospital after CAR-T is about 2 days for proper care and monitoring. The patient is subjected to several biochemical and radiological scans to see that everything is okay and the recovery is on track. After making sure that the patient is clinically stable, discharge is planned.

A. The average rating for CAR-T hospitals in the United Arab Emirates is 4.5. This rating is automatically calculated on the basis of several parameters such as the infrastructure of the hospital, quality of services, nursing support, and other services.

A. There are more than 2 hospitals that offer CAR-T in the United Arab Emirates. These clinics have proper infrastructure for the treatment of patients who require kidney transplants. These hospitals comply with all the rules and regulations as dictated by the regulatory bodies and medical associations in the United Arab Emirates.

A. Some of the best medical specialists for CAR-T in the United Arab Emirates are:

1. Dr. Sivaprakash Rathanaswamy
2. Dr. Peter Loizou
3. Dr. Gilbert Ayoub
4. Dr. Mohanad Diab
5. Dr. Balaji Balasubramaniam
6. Dr. Ali Al Ghrebawi

A. Patients can obtain CAR T-cell therapy in UAE, as it has the best hospitals in the world, which provide the highest level of treatments assisted by a variety of technologies. A number of its medical personnel speak Arabic to make foreigners feel at ease including the sick. Eligibility criteria for CAR T-cell therapy include:

• B-cell Acute Lymphoblastic Leukemia (ALL): Those are pediatric patients and young adults, who are up to 25 years old and have failed prior therapies or were non-responders.
• Diffuse Large B-cell Lymphoma (DLBCL): Of the patients, those undergoing the treatment are adult patients who have relapsed from other treatments or who are first-time non-responders.
• Other types of cancer: Those with Hodgkin’s and non-Hodgkin’s, multiple myeloma, and leukemia.

Patients are generally recommended for CAR T-cell therapy when they are unable to be treated with traditional methods, or when they recur after having at least two types of treatment.

A. The post-CAR-T therapy stay may be short or long and will depend on the initial health of the patient, the type of cancer, and the patient’s response to the therapies.

1. Initial Monitoring: Finally, patients require hospitalization after the CAR-T cell infusion and the average stay ranges from a week to 2 weeks. The period enables the medical team to identify other effects that may occur such as CRS and Neurological Toxicity.
2. Extended Monitoring: Ambulatory follow-up may be needed for 2-6 weeks thereafter with weekly or biweekly appointments in the outpatient department.
3. Blood Tests: The patients are subjected to low hematology during the initial few weeks since chemotherapy is administered before the CAR-T cells target the malignancy. Basic blood counts are crucial to determine hematologic counts especially red blood cells white blood cells, and platelets.
4. Continued Monitoring: Patients are usually reviewed after completion of therapy in 1 to 2-month intervals in the first year after treatment.
5. Return to Normal Activities: Recovery to prior levels of energy, immunocompetence, and general health status may take several months. Patients are able to resume their activities by 3 to 6 months after treatment but it may differ with each patient depending on the recovery from side effects of the treatment.

A. CAR-T therapy is not yet widely offered in the UAE, however, the advancement in the availability of cancer treatment has been a considerable growth. Thus, for blood cancers such as leukemia and lymphoma, the chances of CAR-T therapy are rather positive and fall within International guidelines providing a 60-80% response among patients with relapsed or refractory disease.

In Multiple myeloma, the response rates are comparatively lesser amount and vary from 30% to 60%. and in the case of solid tumors, the efficacy is still restricted but studies are again in progress.

A. In the UAE, CAR-T (Chimeric Antigen Receptor T-cell) therapy is currently for patients with relapsed or refractory blood malignancies like B-cell ALL, Large B-cell lymphoma and multiple Myeloma. Often they are closer to the clinical concept of determining the subject’s admissibility and do not set definite age limits. However, some broad parameters are worth noting:

• Pediatric Patients (Under 18 Years): CAR-T therapy has been approved for children and young adults with relapsed or primary refractory B-cell ALL. In clinical practice children as young as 3 may receive CAR-T therapy, but this depends on the treatment protocol used in a particular hospital and the child’s general condition.
• Common indications of CAR-T therapy include relapsed/refractory lymphoma (e.g. diffuse large B-cell lymphoma) or multiple myeloma, and CAR-T treatment is usually indicated in adults up to 75 years old in many practice settings.
• Most surveys and approvals related to CAR-T therapy have set an upper age limit of 65 or 70 years, but the decision comes down to such patient’s general health to withstand this treatment.

However, age should not be an absolute contraindication to CAR-T therapy because other aspects of a patient’s health, including organ function and overall fitness for treatment, can play a role in determining eligibility for the therapy.

A. Any treatment that is as severe as CAR-T therapy is not devoid of its short-term and long-term consequences. Though it gives a chance of treatment to those patients, who have relapsed or refractory cancer, post-immune checkpoint criteria may contribute to severe long-term toxicities and life-long follow-up.

1. Cytokine Release Syndrome (CRS): In this case the common signs include fever, chills, low blood pressure, and breathing difficulties. Moderate to severe CRS can cause organ dysfunction and may need hospitalization.
2. During the early weeks of follow-up after the completion of the program, patients may remain at risk of infection because of immunosuppressed status whether induced by previous chemotherapy or use of steroids or other immunosuppressive agents. Epidermal marches or visceral recurrences may occur and can be observed after several months or years of treatment.
3. During CAR-T therapy, the body’s immune system is re-trained to look out and eradicate cancerous cells. But this may also contribute to the ability to contract autoimmune diseases in which the body cells are attacked by the immune system.
4. Hypogammaglobulinemia: Some people may need to receive immunoglobulins – proteins that help the body fight against infections – through injections periodically. This could be a lifelong requirement in some cases, primarily in patients who keep experiencing immune suppression even after CAR-T treatment.
5. Chronic Fatigue and Weakness: Patients also said that they felt constant tiredness and general body weakness even after CAR-T therapy and that it might be part of the healing process or CAR-T reprogramming of the immune system. This is worst experienced by patients who received chemotherapy before undergoing CAR-T therapy and may take months and years to heal.

A. The duration of hospitalization after CAR T (Chimeric Antigen Receptor T-cell) treatment in the UAE depends on the chosen management strategy and the patient’s response to treatment as well as the course of side effects and complications. But overall, known strategies regarding CAR-T therapy include several phases.

• Collection of T-Cells (Apheresis): T-cells are then extracted from the patient’s bloodstream using a process known as apheresis and, while this can take 4-6 hours it may require an overnight stay in the hospital.
• Infusion Process: It is during the CAR-T infusion process that the patient is initially hospitalized, and the process occurs on Day 0.
• Some of these effects require the patients to be admitted to the hospital for 1-2 weeks after the administration of CAR-T. However, in some cases, a longer duration may be necessary due to complications that may develop.

The entire procedure in a hospital setting is therefore 3-4 weeks in total from pre-treatment, apheresis, and post-infusion observation period.

A. Everything regarding the care of the patient after this treatment should be properly managed so that any side effects can be detected early to avoid further complications while the effectiveness of the CAR-T therapy is often evaluated. CAR-T therapy causes both acute and long-term side effects, so it is necessary to monitor the patients after the treatment.

1. Vital Signs Monitoring: Monitoring of temperature, blood pressure, pulse, and oxygen saturation rates in efforts to detect serious CRS or infections.
2. Neurotoxicity Screening: It’s necessary to have neurological examinations at least once a week to identify if there are any cognitive problems, confusion, or seizures linked to neurotoxicity.
3. Blood Tests: Frequency of blood tests to monitor organ function, blood cells, and immune system.
4. Symptom Management: Symptomatic therapy, analgesia, antipyretic medications for patients with fever, and supportive therapy for severe CRS or neurotoxicity.
5. Infection Prevention: The patients had immunosuppression and therefore infection would be looked at as a complication, particularly if they previously received chemotherapy.
6. After treatment, the patient will need to make follow-ups to the hospital to check for such side effects that might occur after a few weeks. These visits are usually more within the first three months of the disease.
7. Frequency of Visits: The first three months may entail frequent visits; hence, follow-ups may be less often but are still very necessary. The patients could make appointments to see the clinician after every 2-3 months in the first year after CAR-T therapy.

Since the patient improves gradually, the subsequent appointments will be less frequent, but still, they are critical to monitor the CAR-T therapy efficacy and possible adverse effects on a patient’s condition for years.