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Certain Blood Cancers can be treated with Immunotherapy using chimeric antigen receptor (CAR) T-Cell Therapy. This therapy functions by efficiently transforming your T lymphocytes (T cells) into Cancer fighting machines. In CAR T-Cell treatment, doctors introduce an additional gene that alters your cell activity and increases their capacity to identify and eliminate malignant cells. It is very effective in treating Blood Cancer. If it is unable to completely cure the Cancer, it helps in prolonging the lives of many Blood Cancer patients. It is advised for the treatment of following types of Blood Cancer:

• B-cell acute lymphoblastic leukemia 
• Multiple myeloma
• Diffuse large B-cell lymphoma
• High-grade B-cell lymphoma.
• Follicular lymphoma
• Mantle cell lymphoma
• Primary mediastinal large B-cell lymphoma

Mode of Action

Knowing more about T Cells, which are White Blood Cells in your immune system, may help you comprehend better how CAR T-Cell Therapy functions. Your immune system tracks proteins called antigens present on the surface of invading cells to watch out for invaders, including Cancer cells.

Receptors are proteins on the surface of your T cells. These receptors are able to identify cells with abnormal antigens. When a receptor identifies an aberrant cell, T cells activate, serving as a monitoring mechanism for aberrant cells. In addition to eliminating the aberrant cell, the activated T cell also triggers the other components of your immune system to assist in locating and eliminating the aberrant cell.

However, Cancer cells are not always detected by your T-cell receptors. CAR T cells, which are your own T cells modified to identify a particular antigen on the surface of cancer cells. By introducing a synthetic gene for a chimeric antigen receptor, researchers can modify your T cells. They then encourage the growth and multiplication of the newly generated CAR T cells until there are sufficient cells to efficiently target cancer cells.

CAR T-cell receptors identify and eliminate cancer cells once they enter your bloodstream. Additionally, the cells continue to proliferate, ensuring that you have a steady supply of CAR T cells that are specifically targeting the cancer cells. This treatment is also called a "living drug" because of its sustained delivery and prolonged activity.

Doctors conduct specific tests to differentiate eligible and ineligible Cancer patients for CART-T Therapy:

1. Tumor Antigen Testing (Flow Cytometry & Immunohistochemistry)

• Determines if the cancer cells express the target antigen (e.g., CD19 for B-cell malignancies).
• Eligible: Patients whose cancer cells express the required antigen.
• Ineligible: Patients lacking the target antigen, as CAR-T therapy won't work.

1. Bone Marrow & Disease Burden Assessment (Bone Marrow Biopsy, PET-CT, or MRI)

• Evaluates the extent of cancer spread and residual disease.
• Eligible: Patients with manageable disease burden.
• Ineligible: Those with excessive tumor burden that could lead to life-threatening immune reactions post-CAR-T.

1. Lymphocyte Count (Absolute Lymphocyte Count, ALC)

• Measures the number of functional lymphocytes required for T-cell collection.
• Eligible: Patients with adequate lymphocytes for CAR-T manufacturing.
• Ineligible: Patients with severely low lymphocyte counts.

First, you undergo a process known as leukapheresis to get your white blood cells extracted. During leukapheresis, a machine takes a small amount of your blood, separates the white blood cells, and then gives the rest back to you. To take and return your blood, the doctor treating you will use a central venous catheter. 

Your White Blood Cells will then be immediately transported to the laboratory where specialists will convert them into CAR T cells. Three to six weeks may be needed for this process.

An intravenous line (IV) is used to administer a CAR T-cell infusion, which takes five to thirty minutes. During the procedure, you might have to stay in the hospital. 

• The CAR T cells are kept stored in controlled conditions until they are needed.
• The bag containing CAR T cells is connected to an intravenous line.
• Then CAR T cells start flowing into the bloodstream.

Neurological problems and cytokine release syndrome are the two most common adverse effects. The symptoms of cytokine release syndrome, an inflammatory condition, include:

• Shortness of breath
• Fever
• Low blood pressure
• Heart or lung issues (Rare)

Neurological issues associated with CAR T-Cell Therapy:

• Difficulty speaking
• Balance issues
• Confusion
• Difficulty writing
• Headache
• Seizures
• Tremors or twitching

Other potential side effects are:

• Allergic reaction during infusion
• Fatigue
• Bruising or abnormal bleeding
• Hypokalemia (low levels of potassium)
• Hyponatremia (low sodium levels)
• Increased risk of infections

Because of the potential for serious complications, your doctor might advise that you stay in the hospital post-procedure. The length of your hospital stay might range from seven to ten days, depending on your circumstances and appearance of any side effects. The first month following treatment should then be spent at a location that is accessible by car from your treatment facility. During this time, you have someone with you all the time in case you have adverse affects. Once your T cells are ready, you will need someone to drive for you for two months.

After receiving CAR T-cell treatment, many patients have better quality of life and long-lasting remission. But in the initial weeks after therapy, the journey entails careful observation for any adverse effects, such as cytokine release syndrome (CRS) and neurological alterations. Blood testing, immune function evaluations, and routine follow-ups aid in monitoring recovery. Some people recover rapidly, while others could suffer from extreme tiredness or a compromised immune system that needs supportive treatment and immunisations. Many survivors may now anticipate a cancer-free future with proper post-treatment management because of the ongoing developments in CAR-T therapy.

When other Therapies fail or the Cancer returns (Recurs), CAR T-Cell Therapy stands as a reliable option for treating some types of blood cancer. Sometimes certain Blood Cancers get completely cured using CAR T-Cell Therapy. It can prolong the lives of many Blood Cancer patients.

A research conducted in 2020 monitored children undergoing this Therapy for acute lymphoblastic Leukaemia. Over 85% of the children experienced complete remission after CAR T-Cell Therapy and 60% of such children remained cancer-free for a year after the treatment.

When compared internationally, India's CAR T-Cell Therapy costs are significantly more affordable:
 

Following are the hospitals that providing CAR T-Cell Therapy in India:

Total estimated diagnostic cost for CAR T-Cell Therapy in India is $900 - $2,400. The following cost split will help you in analysing your approximate cost.

MedFlick, your trusted healthcare companion, is dedicated to ensuring that your medical journey goes as smoothly and successfully as possible.

• Individualized Guidance: Personalized guidance throughout your medical journey.
• Access to a broad network of prominent hospitals, top doctors, and skilled surgeons.
• Transparent and Competitive Pricing: A full breakdown of treatment costs that eliminates surprises and offers you cost-effective solutions.
• MedFlick provides everything from travel arrangements to hotel and visa help to lodging.
• Multilingual Support: Breaking down language barriers to allow patients and medical professionals to communicate more effectively.
• The road to a successful CAR T-Cell Therapy is long and winding, full of hope, resilience, and the promise of a brighter future. With MedFlick as your guide, navigating this life-changing adventure becomes simple and liberating.