Chimeric Antigen Receptor (CAR) T-Cell therapy is a personalized immunotherapy that uses your own cells to fight advanced lymphomas. It may be recommended when at least two other treatments have not been effective. Duke is one of three North Carolina centers certified to administer two FDA-approved CAR T-cell therapies for non-Hodgkin lymphoma: Yescarta and Kymriah. Kymriah is also approved for treatment of leukemia in pediatric patients and young adults.
What Is CAR T-Cell Therapy?
CAR T-cell therapy trains a type of your body’s white blood cells, called T-cells, to recognize and fight cancer. The cells are removed from your blood, altered in a lab, then returned to your body through an infusion.
Candidates for CAR T-Cell Therapy
Candidates for CAR T-cell therapy have failed two separate systemic treatments -- which could include chemotherapy or bone marrow or stem cell transplants -- and by a relapsed after each.
Types of non-Hodgkin lymphomas eligible for treatment with Yescarta and/or Kymriah include:
- Diffuse large B-cell lymphoma (DLBCL)
- Primary mediastinal large B-cell lymphoma (PMBCL)
- High grade B-cell lymphoma
- DLBCL arising from follicular lymphoma (FL)
Additionally, Kymriah can also be used to treat patients up to the age of 25 who have some kinds of B-cell acute lymphoblastic leukemia (ALL).
As part of your evaluation to receive CAR T-cell therapy, you’ll consult with Duke specialists to see if it’s right for you. This evaluation includes a meeting with a financial counselor to determine how health insurance may cover this new therapy.
If you aren’t eligible for CAR T-cell therapy, there may be other options for treatment, and we can work with you to see if there are clinical trials offered at Duke to treat your disease in another way.
Duke Health offers CAR T-Cell therapy at the Duke Adult Blood and Marrow Transplant Clinic.
After You Leave the Hospital
Once you’re discharged from the hospital, you’ll visit the Duke Adult Blood and Marrow Transplant Clinic daily for up to 30 days from the day of your infusion so your progress can be evaluated. You will remain at risk for fatigue, high fever, and seizure.
About 30 days after your infusion, you’ll undergo a positron emission tomography (PET) scan, an imaging procedure your oncologist will review with you to evaluate the effectiveness of the CAR T-cell therapy.
If You Have an Emergency
Duke has an FDA-approved Risk Evaluation and Mitigation Strategy Program to address any risks and side effects associated with CAR-T therapy. If you have a medical emergency during your recovery, you’ll use a special ID card to show emergency room staff and providers that you are a CAR-T patient. This will help our team to provide you with specialized treatment.
Staying Nearby During Your Care
Because CAR-T recipients must stay locally for an extended period of time, Duke can work with you to find housing if you’re traveling from outside the Triangle. Duke Patient Information Services will work with you and your loved ones to find nearby affordable lodging. Staff can also check to see if you’re eligible for financial assistance for housing.
Why Choose Duke
A National Standard of Excellence
Duke is accredited to provide CAR T-cell therapy by the Foundation for Accreditation for Cellular Therapy, a nonprofit organization committed to quality care. This means you and your family can feel confident that your providers are among the country’s leaders in using this new therapy.
Advancing Cancer Treatments
Our researchers explore genetic differences among lymphomas that will lead to improved therapies. Novel techniques such as less intense stem cell transplants, pioneered in part at Duke, offer hope to people with lymphoma.
During your care, our cancer support services offer a variety of ways to care for you and your loved ones, including support groups, counseling, and more. You can find a listing of options on our event calendar.
In addition, Duke University Hospital is proud to be named the best hospital in North Carolina, and nationally ranked in 10 adult and 9 pediatric specialties by U.S. News & World Report for 2019–2020.