T cell and dendritic cell therapy are both ways in which the medical world is expanding our understanding of what medicine is and how to treat diseases for which antibacterials and other similar medicines are ineffective. One of the more researched and effective forms of this therapy is called Chimeric Antigen Receptor (CAR) T-cell therapy. This therapy type, according to the Dana-Farber Cancer Institute, collects T cells from the blood of a patient and adds CAR’s onto their surface. These cells are then infused back into the patient and the cells are able to use their new receptors to bind to tumors and kill them.
The therapy works because chimeric antigen receptors are unique in that they are designed for a specific tumor, meaning that when the T cells are removed from the body and programmed to express these CAR’s they are then able to attack the foreign tumor with more accuracy. According to the literature, this type of therapy has been shown to be effective for people with hematopoietic malignancies. Hematopoietic malignancies are cancers that form from mutations in the hematopoietic stem cells of the bone marrow, meaning that the resulting cancer will be either lymphoblastic (cancer of T or B lymphocytes) or myelogenous (cancer of red blood cells, platelets or granulocytes). Non-hodgkin’s lymphoma (NHL) is a cancer that arises from malignancies (most often) in B cells. The disease is classified by the presence of cancerous lymphocytes in the lymph nodes, which can spread to other organs, most commonly the lymphatic system vessels such as the spleen, thymus, tonsils and bone marrow. When someone who has NHL is diagnosed, they are given several treatment options depending on the severity of the disease, including chemotherapy, radiation, bone marrow transplants and CAR T cell therapy.
When a patient elects to do CAR T cell therapy, they have their own T cells taken. They are then grafted with CAR’s for their specific cancer and put back in the body so that they can attack, but there are some potentially dangerous side effects of this therapy. Cytokine release syndrome (CRS) and neurotoxicity are the most common toxicities that can be caused. CRS occurs when cytokines and tumor necrosis factor are released from CAR T cells (and other immune cells), causing a dangerous inflammatory response. These effects can be mitigated by watching patients closely and administering IL-6 blockers when the CRS score becomes too high – as IL-6 is thought to be important to the CRS inflammatory response. The price of even just one transfusion can be more than $350,000 and insurance may not cover even half of it. If the treatment was cheaper it would allow more people access to the potentially life-saving benefits.
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