Blood and Marrow Transplant / Cellular Therapy Program

Bone marrow is the tissue inside the center of your bones, and stem cells are the immature cells that form in the tissue. As stem cells mature, they become:

• Red blood cells, which carry oxygen across your body

• White blood cells, which fight infection

• Platelets, which clot your blood

Stem cells are first collected from the patient or donor and then filtered and frozen. When the patient is ready for transplantation, they will receive the stem cells intravenously.

Patients are then given high doses of chemotherapy and/or radiation, which is intended to eliminate any potentially residual abnormal (cancer) cells and normal cells. The stem cells, which were previously collected, are then infused to “rescue” normal bone marrow function. In a stem cell transplant from a donor, a new immune system from the donor is re-established to monitor for cancer cells.

This whole procedure is done in the hospital to allow for close monitoring and symptom management by our well-trained staff.

CAR T-cell therapy is a form of cellular immunotherapy that uses the patient’s own immune cells to fight cancer. It is primarily used to treat certain types of blood cancers, such as leukemia, lymphoma, and multiple myeloma.

T-cells are a type of white blood cell that play a central role in the immune system. In CAR T-cell therapy, these cells are genetically modified to better recognize and attack cancer cells.

The process involves several key steps:

1. Collection: T-cells are collected from the patient’s blood through a procedure called leukapheresis, which separates white blood cells from the rest of the blood.
2. Engineering: In a specialized laboratory, the T-cells are genetically modified to produce chimeric antigen receptors (CARs) on their surface. These receptors are designed to recognize specific proteins (antigens) found on cancer cells.
3. Expansion: The modified T-cells are then grown and multiplied in large numbers to ensure there are enough cells for treatment.
4. Preparation: Before the CAR T-cells are infused back into the patient, the patient typically receives lymphodepleting chemotherapy. This helps create space in the immune system for the new CAR T-cells to expand and function effectively.
5. Infusion: The engineered CAR T-cells are infused intravenously into the patient. Once inside the body, they seek out and bind to cancer cells that express the target antigen, triggering a powerful immune response that destroys the cancer cells.
6. Monitoring and Recovery: Because CAR T-cell therapy can cause serious side effects—such as cytokine release syndrome (CRS) and neurological toxicities—patients are closely monitored in a hospital setting. Supportive care is provided by a trained medical team to manage symptoms and complications.

CAR T-cell therapy represents a personalized and highly targeted approach to cancer treatment, offering hope to patients who may not respond to traditional therapies.