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Sep 20, 2018

Bone Marrow Transplant and CAR-T Cell Therapy Q&A

By Mayo Clinic Hematology Staff, @mayoclinichematologystaff

Learn more about bone marrow transplants (BMT) and CAR-T therapy with Mohamed A. Kharfan Dabaja, M.D., M.B.A. Dr. Kharfan-Dabaja gives an overview of treatment options and then fields questions from Mayo Clinic Connect and Facebook members.

Bone marrow transplants are now also known as hematopoietic stem cell transplants. There are two types of hematopoietic (BMT) transplants, autologous and allogeneic.

An autologous transplantation is when a patient uses cells from their own body. The process for autologous transplantation is as follows:

  • Patient is given what are called growth factors to stimulate the bone marrow to expand the stem cell pool (4 to 5 days)
  • Patient is connected to an apheresis machine to remove the stem cells (usually 4 to 6 hours but can be longer)
  • After stem cells are administered, patient must stay near a Mayo Clinic facility for an average of 7-14 days for follow up

Allogeneic transplantation uses cells from a donor — typically a matched related donor such as a child or parent. The process for an allogeneic transplantation is as follows:

  • First, a suitable HLA (human leukocyte antigen) compatible donor match must be found
  • The donor must then be tested for any communicable diseases, as well as undergo a physical to ensure the donor is able to handle the procedure as well
  • The patient will undergo conditioning chemotherapy
  • After stem cells are administered, patients must stay near a Mayo Clinic facility for an average of 2 to 2 ½ months

Follow up appointments for each transplantation monitor for recovery and assessments of the disease. Also, appointments will monitor for infections due to the lowered immune systems because of the procedure itself.

CAR-T cell Therapy (chimeric antigen receptor T-cell)

3D-illustration-of-CAR-T-cell--eaf6d313-f954-48bb-ace4-b6ee2a068434-1602651669_pOur bodies contain cells, in this case T lymphocytes, that fight against infections and against cancer. Sometimes, those cells do not function properly or they do not recognize cancer cells. In short, CAR-T therapy isthe re-engineering of your T-cell lymphocytes:

  • Cells are taken from the patient
  • Cells are processed, or manufactured, by introducing cells that are present on the cancer cells
  • Cells are then reinfused in the patient

Patients must meet specific criteria for approved disease that qualify for CAR-T therapy, as well as physical exams to determine the patient can handle CAR-T therapy.

Tune in to the 8:30 minute mark of the video to watch Dr. Kharfan-Dabaja answer questions from Connect and Facebook members.

Click here or more information on CAR-T-cell therapy at Mayo Clinic or to request an appointment.

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