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Frequently Asked Questions About CAR T-Cell Therapy for Leukemia

  • What is Kymriah?

    Kymriah is a type of cellular therapy called CAR T-cell therapy. CAR T-cell therapy uses specially altered T cells – a part of the immune system – to fight cancer. A sample of a patient's T cells is collected from the blood, then is modified to produce special structures called chimeric antigen receptors (CARs) on their surface. When these CAR T cells are reinfused into the patient, the new receptors enable them to latch onto a specific antigen on the patient's tumor cells and kill them.

    Learn more about how CAR T-cell therapy works.

    Clinical trials of Kymriah showed that 83 percent of patients achieved complete remission (i.e., no sign of cancer) within 3 months of treatment.

    Who is eligible to receive Kymriah?

    Kymriah is appropriate for some children and young adults up to age 25 with B-cell acute lymphoblastic leukemia (ALL) that has either not responded or has relapsed after at least two prior treatments.

    For patients ages 18-25, the first step is a referral to DF/BWCC's Adult Leukemia Program for an evaluation. Call us at 877-801-CART (2278), or email cartinquiries@dfci.harvard.edu.

    Patients may also be evaluated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center (Dana-Farber/Boston Children's). To schedule a consultation for your child, call 617-632-5064, or email gene.therapy@childrens.harvard.edu.

    Where is Kymriah available?

    Because Kymriah is a highly complex, highly personalized treatment, it is available at a limited number of specialized cancer centers. Only hospitals that meet quality and technical standards set by Novartis (which makes Kymriah) can offer this treatment. DF/BWCC (for young adults ages 18 to 25) and Dana-Farber/Boston Children's (for any patient under age 25) are certified treatment centers for Kymriah.

    Will my insurance cover Kymriah?

    Health insurers are preparing their coverage policies for this treatment. Currently, coverage is reviewed on a case-by-case basis as is typical when new therapies are first approved. We work with patients and insurers to seek health insurance coverage for clinically-eligible patients.

    What are the side effects of Kymriah?

    There are risks of significant side effects with CAR T-cell therapy. Patients are admitted to the hospital for several weeks so our care team can monitor response to the treatment, and manage reactions to this therapy. The complications are generally temporary and resolve with treatment. Our care team is specially trained to identify and manage these side effects.

    Most patients do not experience the common side effects associated with chemotherapy such as hair loss, nausea, and vomiting. However, possible side effects from CAR T-cell therapy include:

    • Cytokine release syndrome: CAR T cells can initiate a massive release of substances called cytokines, which triggers an inflammatory condition known as cytokine-release syndrome (CRS). Symptoms may be flu-like, with a high fever and/or chills; low blood pressure; difficulty breathing; or confusion. These symptoms can be mild or severe.
    • Neurologic difficulties: Patients may also experience confusion, difficulty understanding language and speaking, or stupor.
    • B-cell aplasia: B cells make antibodies that kill disease cells. B-cell aplasia happens when a large number of B-cells are killed by CAR T-cell treatment. Many patients get immunoglobulin therapy (extra antibodies) to help prevent disease when a patient doesn't have B cells.

    Read more about potential side effects of CAR T-cell therapy.

    See our Frequently Asked Questions About CAR T-cell Therapy for more information.

  • Dana-Farber/ Brigham and Women's Cancer Center
  • Contact Information for CAR T-Cell Therapy

    For more information about CAR T-cell therapy, please call 877-801-CART (2278) or email cartinquiries@dfci.harvard.edu.

  • Pediatric CAR T-Cell Therapy

    Dana-Farber/Boston Children's is a certified treatment center for providing the recently FDA-approved CAR T-cell therapy called KYMRIAH to patients who are up to 25 years old with second or later relapsed or refractory B-cell acute lymphoblastic leukemia (ALL).