Before and during CAR-T administration

CAR-T therapy requires a prior preparation process called apheresis. This is a technique which separates blood components into those necessary for treatment, while the rest is returned to the patient's bloodstream.

Before this step, any immunosuppressive treatment (e.g., corticosteroids) must be stopped to improve the collection of lymphocytes from the blood, so that the CAR-T treatment manufacturing process is optimal.

After apheresis, the patient has to undergo lymphodepletion treatment (removal of lymphocytes) to optimise CAR-T therapy during infusion. Upon admission, the patient is given pre-medication to prevent possible adverse effects of the CAR-T therapy, such as fever.

Little is felt during infusion of CAR-T therapy, as it is infused intravenously, using the same route the patient already has after being hospitalised.

The single most common uncomfortable sensation is unpleasant or “garlic” breath. This is because the substance used to freeze and preserve CAR-T cells is dimethyl sulfoxide (DMSO). Once this substance enters the bloodstream, it is highly volatile and eliminated via exhalation, causing this characteristic smell and taste.