Chimeric antigen receptor (CAR) T-cell therapy treats some types of blood cancer. Scientists create the treatment by adding a lab-made gene to your cancer-fighting T cells. The change helps T cells detect and kill cancerous cells. Healthcare providers may use this treatment when other treatments aren’t effective or blood cancer comes back.
Chimeric antigen receptor (CAR) T-cell therapy is a type of immunotherapy for some types of blood cancer. It works by turning your T lymphocytes (T cells) into more efficient cancer-fighting machines. In CAR T-cell therapy, healthcare providers introduce a new gene into your T cells that changes your cells so they can do more to detect and kill cancerous cells. In some cases, CAR T-cell therapy can cure blood cancer. Other times, it helps people with certain blood cancers live longer.
The Center for International Blood and Marrow Transplant Research collects data from transplant centers. According to the most recent data, there were 22,000 stem cell transplants in 2020. Procedures using peripheral blood stem cells were more common than procedures done with bone marrow and cord blood.
The two types are allogeneic, which uses donated stem cells, and autologous, which uses your own healthy stem cells. Autologous stem cell transplants are slightly more common than allogeneic stem cell transplants.
Each year about 18,000 people in the United States learn they have a disease that a stem cell transplant could cure. People typically have stem cell transplants when other treatments aren’t effective or if their condition comes back after treatment. Healthcare providers may do stem cell transplants to treat different kinds of cancer, including some tumors and blood cancers, blood disorders, and some autoimmune diseases.
Healthcare providers may use stem cell transplants if other treatments aren’t effective or a blood cancer comes back (recurs). For example, providers may use this procedure to treat the following blood cancers:
Blood disorders are conditions that keep parts of your blood from doing their jobs. Healthcare providers may use stem cell transplants to treat:
Providers may use stem cell transplants for the autoimmune disease relapsing-remitting multiple sclerosis or testicular germ cell tumors that come back after chemotherapy.
Healthcare providers typically use stem cell transplants to treat life-threatening cancer or blood diseases. Unfortunately, not everyone who has those conditions can have the procedure. Here are factors providers take into consideration:
If you’re a candidate for a stem cell transplant, your healthcare provider will perform the following tests to confirm you’re physically able to manage transplantation processes, including pre-treatment chemotherapy called conditioning and transplantation side effects:
Before your blood tests, your provider may place a central venous catheter (CVC) in one of the large veins in your upper chest. CVCs eliminate repeated needle sticks to draw blood or insert intravenous tubes throughout the transplant process.
If you’re receiving your own stem cells, your provider may give you medication to boost your stem cell production. They’ll do follow-up blood tests to check on stem cell production.
If you’re receiving your own stem cells, your providers will take blood from you so they can remove healthy stem cells for transplant. Here’s how that works:
The process doesn’t hurt but can take three to four hours. Your providers may need to take blood more than once to be sure they have enough stem cells to transplant.
Whether you’re receiving donated stem cells or your own stem cells, the process may look and feel a lot like receiving medication or a blood transfusion via an intravenous catheter (IV) tube. First, your provider may give you fluids and medication to help prevent side effects or reduce the chance your body may reject the new stem cells. Then they’ll start infusing stem cells. The process may take several hours. While you’re receiving new stem cells, your provider will frequently check for signs of fever, chills, and other potential side effects.
Your new stem cells will need time to produce new blood cells. If you received donor stem cells, your transplanted stem cells will replace unhealthy stem cells and begin to build a new immune system. This process is called engraftment.
Either way, you may need to stay in or close to the hospital for several months so your healthcare providers can support your recovery and check on your progress, including how many new blood cells your stem cells are making. Here’s what you can expect after your stem cell transplant:
Stem cell transplants may help to cure or slow certain blood cancers or blood disorders that didn’t respond to other kinds of treatment.
The greatest risk is that you’ll go through the procedure and your transplanted stem cells can’t slow or eliminate your illness.
Potential complications will vary based on your overall health, age, and previous treatment, including pre-transplant chemotherapy (conditioning). If you’re considering a stem cell transplant, your healthcare provider will outline potential complications so you can weigh those risks against potential benefits. Allogeneic stem cell transplants are more likely to cause complications, such as:
It can take several months up to a year to fully recover from a stem cell transplant. Your healthcare provider may recommend you stay in or near the hospital or transplant center for the first 100 days after your procedure.
That depends on your situation. People who have autologous stem cell transplants may be able to return to onsite work or school within four months. But if you had an allogeneic stem cell transplant, it may be a full year before onsite work or school makes sense. As you recover, ask your healthcare provider about recommendations for returning to onsite work or school.
A successful stem cell transplant can change your life, curing your condition or slowing its growth. But it’s not an overnight transformation. It can take a year or more for you to recover. Here are some challenges and ways to overcome them:
It’s difficult to calculate an overall success rate. That said, the most recent data show the highest number of stem cell transplants involved people with multiple myeloma or Hodgkin and non-Hodgkin lymphoma who received autologous stem cell transplants. Here’s information on three-year survival rates:
You’ll have regular follow-up appointments with your provider. But it’s important to remember your immune system will likely be weak for a year or so after your transplantation. Contact your provider right away if you develop any of the following symptoms:
For more than 40 years, healthcare providers relied on donated bone marrow to get the healthy stem cells they needed to do stem cell transplants. Now, nearly all transplants use stem cells obtained from people’s blood, which is a less complicated process.
