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What is CAR-T? Enlarged image of red and white blood cells.
 

CAR-T therapy is a type of immunotherapy that uses a person’s own immune cells, called T cells, and makes them stronger so they can identify and attack cancer cells. First, T cells are removed from a patient’s blood. Next, the cells are modified in a laboratory, adding the gene for a molecule receptor called a chimeric antigen receptor (CAR). Millions of these CAR-T cells are grown in the laboratory, and then given back to the patient through an infusion. These new cells can seek out cancer cells, attach to them and destroy them.

Why choose Johns Hopkins for CAR-T?

Our center is a National Cancer Institute-designated Comprehensive Cancer Center with a long history of accomplishments in the field of blood and bone marrow cancers. Our experts helped develop, and continually expand, the field of bone marrow transplantation and cellular therapy.

 

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Frequently Asked Questions

    • You will have an intravenous (IV) catheter put in your chest prior to the collection.
    • You will need to stop eating and drinking after midnight the day before your catheter is placed.
    • You will go to the Hemapheresis and Transfusion Support (HATs) Department to have your cells collected.
    • The CAR-T cell collection is called apheresis. Your blood will be removed through the catheter and filtered through a machine that will collect your T cells in a bag. The remaining blood is returned to you through the catheter.
    • You will be watched very closely by a specialized apheresis nurse who is trained to use the machine and care for you during collection.
    • The collection will take about four hours. When it is finished, we will remove the catheter.
    • The cells will be shipped to a lab to be genetically modified and prepared for infusion. Then, the cells are frozen and shipped back to Johns Hopkins. This process takes about two to four weeks.
    • You may get chemotherapy during this time period if your doctor thinks it is needed.
    • Once the cells are ready for infusion, we will put in a peripherally inserted central catheter (PICC), which is a special IV in your arm.
    • You will then be given chemotherapy two to three days prior to the infusion to help prepare your body to receive the CAR-T cells.
    • The infusion of CAR-T cells will be done either through the Inpatient/Outpatient Program (IPOP) for patients with blood and bone marrow transplant and blood cancers, or in the inpatient unit.
    • The cells will be given through your peripherally inserted central catheter (PICC) line. You will be monitored during and after the infusion by your team, and your vital signs will be taken frequently.
    • We will continue to watch you closely for potential side effects of CAR-T cell therapy, such as cytokine release syndrome or other neurological toxicities.
    • Plan to stay within a one-hour drive of the cancer center for up to four weeks after the infusion for monitoring, and make sure to have a caregiver with you during this period.
    • You should not drive, operate heavy machinery, or do other potentially dangerous activities for four to eight weeks after the infusion. Your provider will tell you how long you need to wait.
    • We will continue to watch you closely for potential side effects of CAR-T cell therapy, such as cytokine release syndrome or other neurological toxicities.
    • Plan to stay within a one-hour drive of the cancer center for up to four weeks after the infusion for monitoring, and make sure to have a caregiver with you during this period.
    • You should not drive, operate heavy machinery, or do other potentially dangerous activities for four to eight weeks after the infusion. Your provider will tell you how long you need to wait.
    • CAR-T cells may cause confusion and memory problems, difficulties speaking, hallucinations or seizures. These symptoms most often occur within the first eight weeks after infusion and usually are temporary . Your treatment team is prepared to identify and treat these symptoms if needed.
 
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