Planning for Chimeric Antigen Receptor (CAR) T-Cell Therapy

First steps

• Planning for your CAR T-cell therapy an ongoing process. You will meet with your interdisciplinary team as part of the planning and evaluation phase, including an Oncology Physician, Nurse Coordinator, Social Worker and Financial Counselor.
• This therapy is expensive and may require financial clearance with your health insurance provider.
• There will be multiple medical tests to help determine if this therapy is right for you.
• You may need to see other physician consultants, including Cardiology, Psychiatry, and/or Infectious Disease.
• If CAR T-cell therapy is recommended by the oncology team and approved by your health insurance, dates of treatment will be scheduled. Sometimes treatment dates change due to a variety of reasons. You will be kept informed of these changes.

It is a process

• Before you can receive your CAR T-cell infusion, your blood will be filtered through a machine that collects some of your T-cells. You will require a temporary catheter to collect these cells. This collection happens in our outpatient Oncology Infusion clinic and typically takes 4-6 hours.
• Your cells are then shipped to a laboratory and modified to contain CAR T-cells.
• Approximately 3 weeks later, your CAR T-cells will be ready for infusion. First, you will receive 3 days of low dose chemotherapy in the Oncology Infusion clinic.

For inpatient hospitalization

• Your CAR T-Cell infusion requires you to be admitted to the hospital for approximately 7 – 14 days following the CAR T-cell infusion to be monitored for side effects. You will be admitted to the oncology unit the night before you are due to receive your CAR T-Cell Infusion.
• Having a family member/caregiver with you at this phase is important for support. The family member/caregiver will be able to notice any subtle changes in your general condition and alert the treating team. Please make sure it is the same family member/caregiver as they will be aware of your condition and treatment plan.
• After discharge from the hospital, you and the identified family member/caregiver must stay within 1 hour of driving distance from Cleveland Clinic Abu Dhabi’s Hospital for 4 weeks following your CAR T-cell infusion.
• The identified family member/caregiver must stay with you 24 hours a day for 4 weeks following your CAR T-Cell infusion.
• Do not drive or operate heavy machinery for 8 weeks after your CAR T-cell infusion.

Workplace considerations

• Patients who receive CAR T-Cell therapy are typically off work for 3 months.
• If you are currently working, talk with your employer about applying for extended Sick leave.