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What is CAR T?

CAR T-cell therapy (CAR T) is a type of immunotherapy that uses T cells from your immune system to make your treatment. The full CAR T treatment process has many steps but generally only happens once.

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Watch: What is CAR T?
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What does CAR T involve? How does CAR T work with my immune system? What is the CAR T treatment process like? What are the steps to CAR T?

What does CAR T involve?

CAR T involves:

Collecting your T cells from your blood and sending them to a specialized facility

Changing your T cells into CAR T cells

Returning your CAR T cells to your blood, where they may help your immune cells find and fight cancer

Illustration of patient with the CAR T process explained.

How does CAR T work with my immune system?

Explaining how CAR T works

You can think of the T cells in your body as fighters, and CARs (Chimeric Antigen Receptors) are like special goggles that T cells use to see hidden cancer cells.

[Tap to play] Thumbnail for a video titled: Explaining how CAR T works.
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[Tap to play] Thumbnail for a video titled: Explaining how CAR T works.
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  1. The body's immune system includes T cells. One job of T cells is to find and fight off cancer cells.
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  1. But some cancer cells can hide from T cells. It's like the cancer cells have turned invisible to the T cells and can continue to grow.
  1. As part of treatment, T cells are changed so they can make CARs (Chimeric Antigen Receptors). CARs are like special goggles that T cells use to see hidden cancer cells.
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  1. T cells with CARs are called CAR T cells. CAR T cells can “see” the cancer cells and help fight them off.
T cells are a type of white blood cell in your body. White blood cells are part of your immune system.
Illustration of T cells finding and fighting cancer cells.

1. Normally, T cells help to find and fight off infections and cancer cells in the body.

Illustration of T cell unable to see cancer cells.

2. In some cancers, cancer cells can hide from your T cells. When your T cells can't "see" the cancer cells, this may allow cancer to grow.

Illustration showing how Chimeric Antigen Receptor and T cell become CAR T cell.

3. CAR T can help your T cells fight cancer again. It does this by adding a CAR to your T cells. CAR stands for Chimeric Antigen Receptor.

Illustration of CAR T cells finding and fighting cancer cells.

4. Once in your body, your CAR T cells can help find and fight cancer cells.

Illustration of overactive immune system next to patient and nurse.

5. After receiving your CAR T cells, your immune system may become overactive. As a result, you may experience side effects. Your CAR T treatment team is specially trained to monitor and manage these side effects.

What is the CAR T treatment process like?

CAR T-cell therapy is given as an infusion. The entire treatment process can take several weeks, but it generally happens once. You, your caregiver, and your healthcare team will make a plan that's unique to you and adjust as needed along the way.

Watch: What's it like to get CAR T?
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Patient stories: My CAR T experience

“The waiting period between the decision to proceed with CAR T and actually receiving the cells was the hardest time of the entire process, because you're just looking at a clock.”

- Marc, CAR T patient

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Patient stories: My CAR T experience

Judy, CAR T patient
Marc, CAR T patient

JUDY: You don't go through this alone, you know? These people are in it with you, so I feel like they have to participate and understand. I was expecting my doctor to tell me there was nothing for me, and he didn't. He explained CAR T and I was … my family was excited. I was telling everybody. The education, obviously, came from the doctor and they were all very supportive. And so, the decision was made to go forth.

MARC: The day we made the decision to proceed with CAR T, it was a very big decision. I had a lot of mixed emotions, as did my wife, Melissa. I tried other treatment options before and they didn't turn out how I expected. It's an incredibly intense moment, and because my doctor was so open and honest with me and we had that relationship of trust, it was easier for me to focus on the decision.

JUDY: I remember going into the location where they were going to collect my blood, my T cells from my blood. My doctor asked me to come back a few weeks later to have the CAR T-cell therapy treatment. The day that the infusion was happening, you're scared. I knew the seriousness of it.

MARC: The waiting period between the decision to proceed with CAR T and actually receiving the cells was the hardest time of the entire process, because you're just looking at a clock. You just want to get to the point where you can start to have the treatment that might help you.

As much as we could, we would spend our time doing bike rides, going for walks, doing puzzles—anything like that to distract us, but the emotion is what's most important. It's part optimism and it's part trying to create lasting memories, knowing that our time might be limited together. I remember the day when I went to get the infusion. It was an exciting day—we were finally there. It was exciting in that we had finally reached that moment.

JUDY: Knowing that there was a treatment took pressure off me. When I went into the hospital, they educated me. They were very excited—they were seeing good things happening to people, and they were just as excited as I was. Now that, in and of itself, made me very comfortable.

Patient stories: After my CAR T infusion

"I was in the hospital for about two weeks for my recovery. Every day, the doctors and nurses would examine me and run tests."

- Judy, CAR T patient

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[Tap to play] Thumbnail for a video titled: Patient stories: After my CAR T infusion.

Patient stories: After my CAR T infusion

Darrin, CAR T patient
Judy, CAR T patient

DARRIN: I asked my doctor a lot of questions, one of the big concerns was how long of a recovery was this going to be. What would we expect? So the recovery time for this, he said, “You’ll probably be in the hospital seven to ten days after you receive your T cells, and then you’ll need to be nearby for up to 30 days from the time you receive your T cells.”

JUDY: I was in the hospital for about two weeks. Every day the doctors and nurses would examine me and run tests.

DARRIN: In the beginning, I was kind of worried about some of the side effects my doctor told me might occur after treatment. In the first few days of recovery, I felt okay. After the first full week of recovery, that’s when I started to experience more of the serious side effects.

JUDY: I did have four days where I experienced neurological effects. I cannot remember anything of those four days. They explained that that's normal—this is just my experience, and others may have different experiences.

DARRIN: About a week into my recovery is when I started having trouble speaking. This only lasted for a few days for me. My healthcare team would run tests each day, and ask questions to test my memory and neurological function. Some of these questions were as simple as, “What’s this?” and it’s the clock on the wall. “Who’s the president?”—things that certainly I would know.

JUDY: During my recovery process, you actually see a lot of your health team. I relied on them heavily. They were so positive. My healthcare team told me to do what I need to do to rest, to listen to my body, and they made it very comfortable for me to say it's okay to sleep.

DARRIN: Staying near my treatment facility was a weeks-long process. We had neighbors that were able just pop up and say, “Hey, don’t worry about your lawn. We’ll take care of your lawn.” And so they mowed our lawn for us. With my healthcare team and friends and family checking on me all the time, I certainly felt like I wasn’t going to fall through the cracks.

What are the steps to CAR T?

Illustration of patient and caregiver speaking with an oncologist.

Attending your CAR T consultation

You'll meet the team at a CAR T medical center. This consultation will include various tests and checks to make sure CAR T is right for you.

What happens?

Average time: 1 day or more
Where: CAR T medical center

How might I prepare for this step?

To help prepare, you can:

  • Plan a visit before your CAR T consultation—this can help you get a better sense of the location and how to get around

Questions you can ask:

  • How long will I need to be at the CAR T medical center? What should I expect and who will I meet?
  • Will I have more than one appointment as part of the consultation?
  • What should I bring to my appointment(s)? (e.g., insurance card, etc.)
  • If needed: Do you have suggestions for parking, lodging, transportation, food, etc.?
  • What else can I do to prepare for the appointment(s) for my CAR T consultation?
Illustration of patient having their T cells collected at a CAR T medical center.

Collecting your T cells (apheresis or leukapheresis)

At the CAR T medical center or apheresis center, your T cells will be collected from your blood.

What happens?

Average time: 1 day
Where: CAR T medical center or apheresis center

  • This procedure can take about 4 hours
  • You'll be seated in a reclining chair or bed
  • Blood from your arms or a central catheter is run through a machine that collects your white blood cells, including your T cells
  • The rest of your blood is returned to your body
  • The collected T cells will be used to make your CAR T treatment
How might I prepare for this step?

To help prepare, you can:

  • Wear loose and comfortable clothing that allows access to both of your arms or your central catheter
  • Bring something that helps you feel comfortable and can help pass the time (e.g., music, book, tablet, etc.)
  • Ask a caregiver to keep you company and to drive you home—you may feel tired after the procedure

Questions you can ask:

  • How much time will I need to spend at the CAR T medical center?
  • What should I expect and who will I meet?
  • What else can I do to prepare for this appointment?
Illustration of T cells being changed into CAR T cells at a specialized facility.

Waiting for your CAR T cells

You'll wait for a few weeks, at home or near the CAR T medical center, while your CAR T cells are made at a specialized facility.

What happens?

Average time: 2 to 4 weeks, but can be longer
Where: At home or near the CAR T medical center

What can I do while I wait?

While waiting, you can:

  • Follow your healthcare team's guidance about what you can do to stay well—physically, mentally, and emotionally
  • Talk to someone in your support network and/or a professional if the wait is stressful or challenging
  • Learn more about lymphodepleting chemotherapy (LDC) and the CAR T infusion

Questions you can ask:

  • Will I need another treatment while waiting for my CAR T cells to be made?
  • Roughly how long will it take to make my CAR T cells and how will I know when they're ready?
  • Where should I stay while waiting for my CAR T cells to be made?
  • What can I do to stay well during this time?
Illustration of a patient receiving lymphodepleting chemotherapy through IV.

Preparing your body to receive your CAR T cells

Before your CAR T infusion, you'll receive a low dose of chemotherapy to prepare your body for CAR T.

What happens?

Average time: 3 days for lymphodepleting chemotherapy (LDC), 2 days rest
Where: LDC at a clinic or the CAR T medical center, rest at home

  • LDC can start 2 to 14 days before you receive your CAR T cells
  • You'll receive LDC each day, for 3 days, but the timing may vary
How might I prepare for this step?

To help prepare, you can:

  • Wear loose and comfortable clothing that allows access to both of your arms or your central catheter
  • Make sure your caregiver is with you
  • Bring something that can help you and your caregiver pass the time (e.g., music, book, tablet, etc.)

Questions you can ask:

  • What will my LDC schedule be like?
  • What are the possible side effects of LDC?
  • What else can I do to prepare for LDC?
  • Will I get to go home between LDC and my CAR T infusion?
Illustration of a patient being monitored by their doctor and caregiver.

Receiving your CAR T cells and staying at or near the CAR T medical center for close monitoring

You'll return to the CAR T medical center to receive your CAR T infusion. You will need to stay at or near the CAR T medical center while your CAR T treatment team takes care of you and manages any side effects.

What happens?

Receiving your CAR T cell infusion
Average time: 1 day
Where: At the CAR T medical center

  • You will be at the CAR T medical center for a number of hours so that your CAR T treatment team can get you prepped for the infusion and monitor you afterwards
  • Your CAR T infusion may take about 15 minutes
  • Some CAR T medical centers require you to be admitted to the medical center for the procedure, while others offer CAR T in a clinic

Staying at or near the CAR T medical center for close monitoring

Average time: At least 4 weeks
Where: At or within 2 hours of the CAR T medical center

  • Your CAR T treatment team will be taking care of you and managing any side effects—they'll tell you and your caregiver what side effects to watch for
  • Your caregiver will also play a key role in watching out for any side effects that you may not recognize yourself
  • Remember to share how you're feeling with your CAR T treatment team
How might I prepare for this step?

To help prepare, you can:

  • Make arrangements if you'll need to be away from home during this time. For example:
    • Book time away from work
    • Arrange home, family, or pet care
    • Pack essentials and clothing for your stay
    • Consider bringing a comfort item that reminds you of home or loved ones (e.g., a favorite item, piece of clothing, photo, etc.)
    • Plan for any transportation, meals, and lodging needs
  • Have a caregiver stay with you and help you with things like transportation
  • Learn more about some of the possible CAR T side effects and how to look out for them

Questions you can ask:

  • What will the day of my CAR T infusion be like?
  • What are the possible side effects of CAR T?
  • How long will I stay at or near the CAR T medical center after infusion?
  • If I need help with finances, travel, and/or other logistics, who can I ask?
  • How will I know if side effects are happening, and what should I watch out for?
  • Who should I contact if I think I'm experiencing symptoms, and when?
  • How will side effects be managed?
  • How can my caregiver help during this time?
Illustration of a caregiver and patient sitting beside calendar.

Recovering at home

When your CAR T treatment team feels that you are ready, you will return home and continue to have follow-ups with your healthcare team(s).

What happens?

Average time: Varies by patient
Where: At home

  • Your follow-ups may be at the CAR T medical center, or you may go back to your local cancer clinic and primary doctor
  • You may feel tired for a while and may need help to regain your energy and strength
  • You will continue to rely on your caregiver(s) while you're getting back to your daily activities—you should not drive for 8 weeks after your CAR T infusion
  • You and your caregiver will be asked to continue watching out for symptoms at home
  • Your healthcare team will give you more guidance on what is recommended for you during this time
How might I prepare for this step?

To help prepare, you can:

  • Learn more about some of the possible CAR T side effects and how to watch out for them
  • Arrange for a caregiver or someone else to do any driving for you since you should not drive for 8 weeks after your CAR T infusion
  • Keep track of how you're feeling (e.g., journal, notebook, etc.), so you have a record of any changes
  • Write down all the medications you'll need to take at home
  • Avoid infections by practicing good hygiene and/or arranging for help to keep your home clean
  • Plan and prepare meals recommended by your healthcare team that can support your recovery and reduce the risk of food poisoning

Questions you can ask:

  • Who should I contact if I'm not feeling well and when should I reach out?
  • What are the signs of an emergency medical situation?
  • Are there long-term side effects?
  • Will my daily activities be restricted while I recover?
  • What should I do to stay safe and prevent infections while I'm recovering at home?
  • What kinds of medications or tests may I need after CAR T?

What questions might I ask my CAR T treatment team?

  • What are the steps for me to get CAR T?
  • How can I prepare or plan for CAR T?
  • How many times will I have to go to the CAR T medical center?
  • How long will each step take for me?
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Continue learning

Who is CAR T for? What can I expect?

Next steps

Illustration of patient and caregiver discussing CAR T with an oncologist.

Ask a healthcare provider to learn more about CAR T
Illustration of two people on the phone, chatting one-on-one about CAR T.

Talk to a patient or caregiver who has CAR T experience
Illustration of two people walking from a CAR T medical center.

Find a CAR T medical center