CAR-T cell therapy in India

Cancers Treated by CAR-T Therapy

CAR-T cell therapy is a revolutionary advancement in cancer treatment, particularly for blood cancers that have proven difficult to treat with traditional methods. It is most commonly used in patients whose cancer has relapsed (come back after treatment) or is refractory (not responding to other treatments).

Acute Lymphoblastic Leukemia (ALL)

One of the first cancers approved for CAR-T therapy, acute lymphoblastic leukemia mainly affects children and young adults. In this condition, the bone marrow produces immature white blood cells (lymphoblasts) that crowd out healthy cells.

Symptoms may include:

• Frequent infections
• Easy bruising or bleeding
• Bone and joint pain
• Fatigue and pale skin
• Swollen lymph nodes

CAR-T therapy has shown remarkable success in inducing remission, especially in children and young adults with relapsed or treatment-resistant ALL.

Diffuse Large B-Cell Lymphoma (DLBCL)

This is the most common type of non-Hodgkin’s lymphoma in adults. It grows quickly and can become life-threatening if not treated promptly. CAR-T therapy offers a targeted option for patients who don’t respond to chemotherapy or stem cell transplants.

Symptoms often include:

• Swollen lymph nodes
• Fever or night sweats
• Sudden weight loss
• Fatigue

In many cases, CAR-T therapy has significantly extended survival and improved quality of life.

Mantle Cell Lymphoma (MCL)

Mantle cell lymphoma is a rare and aggressive form of non-Hodgkin’s lymphoma. It often responds to treatment initially but tends to relapse. CAR-T cell therapy provides a promising second-line or third-line treatment option.

Follicular Lymphoma

This is a slow-growing (indolent) type of non-Hodgkin’s lymphoma. Although many patients respond to early treatments, it can come back over time. CAR-T therapy is being used successfully in some relapsed or refractory cases, showing long-lasting results.

Multiple Myeloma

Although not a type of lymphoma or leukemia, multiple myeloma—a cancer of the plasma cells in the bone marrow—is now being treated with newer generations of CAR-T therapies. These therapies are tailored to target the BCMA protein found on multiple myeloma cells, offering hope to patients after other options have failed.

Why CAR-T Works Best for Blood Cancers

Unlike solid tumors, blood cancers are more accessible to circulating immune cells. CAR-T cells, once infused, can travel through the bloodstream and target cancer cells wherever they are—making this therapy especially effective for leukemia, lymphoma, and myeloma.

CAR-T Cell Therapy Procedure in India

The procedure for CAR-T cell therapy is complex but highly targeted. Here is an overview of the steps involved:

1. T-cell Extraction: First, T-cells are collected from the patient’s blood through a process called leukapheresis.
2. Genetic Modification: These T-cells are then sent to a laboratory, where they are genetically modified to produce chimeric antigen receptors (CAR) on their surface. These receptors help the T-cells identify and attack cancer cells more effectively.
3. Cell Multiplication: The modified T-cells are multiplied in the lab to produce millions of CAR-T cells.
4. Re-infusion: After preparation, the CAR-T cells are re-infused into the patient’s bloodstream, where they begin their work of identifying and destroying cancer cells.
5. Post-procedure Monitoring: Patients are closely monitored after the therapy to check for any potential side effects and to ensure that the CAR-T cells are working as intended.

This personalized treatment requires specialized facilities and trained professionals, which is why it is currently available at selected hospitals in India.

How Long Does CAR-T Cell Therapy Take?

CAR-T cell therapy isn’t a single treatment done in one day—it’s a step-by-step process that usually takes several weeks to a couple of months from beginning to recovery. Here’s a simple breakdown of what the timeline typically looks like:

1. T-Cell Collection (Apheresis) – 1 Day

It all starts with collecting the patient’s T-cells through a process called apheresis. This involves drawing blood, separating out the T-cells, and returning the rest of the blood to the body. The entire process takes about 3 to 6 hours and is usually completed in one day.

2. T-Cell Modification – 2 to 3 Weeks

Next, the collected T-cells are sent to a specialized lab where they are genetically modified to better recognize and attack cancer cells. This lab process typically takes 2 to 3 weeks, depending on the facility and logistics.

3. Pre-Treatment Chemotherapy – 3 to 5 Days

Before reintroducing the modified cells, the patient undergoes a short course of lymphodepletion chemotherapy. This step helps create space in the immune system so the CAR-T cells can expand and function better once infused.

4. CAR-T Cell Infusion – 1 Day

Once the lab-modified CAR-T cells are ready, they are infused back into the patient’s bloodstream, much like a blood transfusion. This procedure usually takes just a few hours and is done in a controlled clinical setting.

5. Monitoring and Recovery – 2 to 3 Weeks

After the infusion, patients are carefully monitored for any side effects. Most stay in the hospital for about 7 to 14 days, though some may be treated as outpatients if their condition allows. Recovery monitoring continues for 2 to 3 weeks, with a focus on managing side effects such as cytokine release syndrome (CRS) or neurological symptoms.