CAR‑T: engineered T-cell therapy

CAR‑T vs stem-cell transplant

CAR‑T uses genetically engineered immune T cells; transplantation restores blood formation using hematopoietic stem cells. They are different procedures, and clinical sequencing is individualised.

Which patients may be evaluated?

• Selected relapsed/refractory B-cell acute lymphoblastic leukaemia (B‑ALL)
• Selected B-cell lymphomas after relapse or inadequate response
• Some relapsed/refractory multiple myeloma cases using BCMA-directed products, subject to local approval and availability
• Eligibility varies by product, age, tumour target, previous lines and fitness; most solid-tumour use is investigational

CAR‑T pre-treatment workup

• Confirm pathology, flow cytometry and target antigen such as CD19 or BCMA
• PET-CT/CT and marrow biopsy or MRD when clinically indicated
• CBC, kidney and liver, coagulation and inflammatory markers
• HBV/HCV/HIV and other infection screen; pregnancy testing when indicated
• Echo/ECG, pulmonary and performance review and baseline neurological assessment
• Review steroids, immunosuppressants and other medicines; do not stop treatments without advice

CAR‑T treatment journey

1. Eligibility review

   Clinician confirms disease, product and treatment suitability.

2. Leukapheresis

   Patient T cells are collected from blood and shipped for manufacture.

3. Engineering and expansion

   CAR expression is added and cells grown; manufacture may take several weeks.

4. Bridging if needed

   Temporary treatment may control disease during manufacture.

5. Lymphodepletion

   Short chemotherapy regimen precedes the cell infusion.

6. Infusion and observation

   CAR‑T cells are infused; watch for CRS, ICANS, infection and cytopenias.

7. Follow-up

   Response testing, immunity support and long-term toxicity surveillance.

Major safety considerations

• Cytokine-release syndrome (CRS): fever, sometimes severe low blood pressure or breathing problems
• Neurotoxicity (ICANS): confusion, speech impairment or seizures
• Cytopenia, infections, low antibodies and possible late complications
• Treatment must occur in a centre able to manage emergencies; no universal price or cure rate

Hospitals with published CAR‑T information

These centres publish CAR‑T information on official hospital pages. Confirm available products, indications, capacity and dates individually.

BLK‑Max and Indraprastha Apollo Delhi: report assessment can be arranged, but service availability at the exact branch requires direct written confirmation.

Medical references