Cellular Therapies for Your Patients

Our Cellular Therapies Program at Dana-Farber Brigham Cancer Center builds on our expertise in stem cell transplantation. Cellular therapies are designed to improve the immune system's ability to fight cancer. Manufacturing them involves collecting a specific set of cells from the blood, modifying them to produce a more vigorous attack on a patient's cancer cells, and then reinjecting them into the patient. Cells are processed at an outside commercial facility or at the Connell and O'Reilly Families Cell Manipulation Core Facility, which has long been at the forefront of producing cell-based therapies for cancer and other diseases.

Many types of cellular therapy for cancer are being explored, including CAR T cells, other genetically modified T cells, tumor infiltrating lymphocytes (TIL), vaccines, and NK cells.

Stem Cell Transplant and Cellular Therapies Guide

Why Choose Us

In-depth knowledge: We understand how to manage the complex treatment plans and unique side effects of cellular therapies.

Extensive evaluation: Our team carefully evaluates each patient to determine if cellular therapy  is appropriate.

Specialized team: Our clinical and administrative teams have deep experience and understanding of the needs of cellular therapies patients.

Disease-specific expertise: We offer commercial and clinical trial cellular therapies to patients with blood cancers and solid tumors.

State-of-the-art, in-house cell processing lab: The Connell and O'Reilly Families Cell Manipulation Core Facility is a critical component of our program, processing cellular products for stem cell transplant and CAR T-cell therapies.

Strong partnerships: Dana-Farber partners with Brigham and Women's Hospital, one of the nation's leading hospitals, to care for patients. In addition to a dedicated transplant physician and nurse practitioner, patient care may include expert specialists in infectious disease, dermatology, neurology, pulmonology, and more – all with a deep understanding of the complex needs and complications of patients receiving these advanced therapies.

Patient Referrals and Consults

Call 877-442-3324 to discuss if CAR T-cell therapy is right for your patient. See our referral timing guide for detailed recommendations by disease type. Early referral for evaluation is recommended.

Payer & Provider Collaboration: Advancing Patients Through Cellular Therapy Treatment

This webinar from June 14, 2023, provides an update on CAR T-cell therapy, with a focus on which patients may be appropriate for cellular therapy treatment. It covers the current state and future vision for cell therapies, as well as best practices for working together to ensure patients receive timely access to necessary care.

0:03 – Welcome, Introduction
Amy Emmert, MScPH, Executive Director for Cellular Therapy External Affairs; Kidest Mequanent, Senior Program Manager for Cell Therapies and Shared Care

7:39 – Current State and Future Vision of Cell Therapies in Lymphoma, Leukemia, and Solid Tumors
Caron Jacobson, MD, MMSc

24:56 – Current State and Trends in Multiple Myeloma
Omar Nadeem, MD

40:52 – Financial Operations and Workflows Overview
Pat Kelley, BSN, RN

51:35 – Q&A

Commercial CAR T-Cell Therapy

We offer all commercial CAR T-cell therapies that have been approved for:

  • Aggressive relapsed or refractory large B-cell lymphoma, including diffuse large B-cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma, high-grade B-cell lymphoma, and transformed follicular lymphoma
  • Relapsed or refractory mantle cell lymphoma
  • Relapsed or refractory follicular lymphoma
  • Relapsed of refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL)
  • Relapsed or refractory multiple myeloma
  • Relapsed or refractory B-cell acute lymphoblastic leukemia (ALL)

We also offer several CAR T-cell therapy clinical trials for several types of blood cancers and for patients at various stages of treatment.

How Does CAR T-Cell Therapy Work?

CAR T-cell therapy, like all forms of cancer immunotherapy, seeks to sharpen and strengthen the immune system’s inherent cancer-fighting powers. It involves treating patients with modified versions of their own immune system T cells ­– white blood cells that help protect the body from disease.

CAR T for Lymphoma

Aggressive non-Hodgkin Lymphoma

  • Confirmed diagnosis of DLBCL, primary mediastinal large B-cell lymphoma, high-grade B-cell lymphoma, or transformed follicular lymphoma to DLBCL that has relapsed or not responded to at least two prior lines of systemic therapy, if the initial response to first-line therapy was longer than 12 months.
    • Patients with these diagnoses who do not achieve remission or relapse within 12 months of first-line therapy are eligible for CAR T as a second-line therapy.
    • Patients with DLBCL that has relapsed or not responded to first-line treatment and are not eligible for stem cell transplant are eligible for CAR T as a second-line therapy.

Mantle Cell Lymphoma

  • Histologically confirmed diagnosis of mantle cell lymphoma that has either not responded to, or relapsed after first line of therapy.

Follicular Lymphoma

  • Confirmed diagnosis of follicular lymphoma that has relapsed or not responded to at least two prior lines of systemic therapy.

Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma

  • Confirmed diagnosis of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) that has relapsed or not responded to at least two prior lines of therapy, including a Bruton tyrosine kinase (BTK) inhibitor and a B-cell lymphoma 2 (BCL-2) inhibitor.

More on CAR T-cell therapy for lymphoma

CAR T for Leukemia

  • Confirmed diagnosis of B-cell acute lymphoblastic leukemia (ALL) that has either not responded or has relapsed after one line of prior treatment.
  • Adequate organ, cardiac, and pulmonary function (must meet established criteria/measures).

More on CAR T-cell therapy for leukemia

CAR T for Multiple Myeloma

  • Confirmed diagnosis of multiple myeloma that has relapsed or not responded (refractory) after four or more prior lines of treatment.
  • Prior therapy must have included a proteasome inhibitor, an immunomodulatory drug, and an anti-CD 38 monoclonal antibody.

More on CAR T-cell therapy for multiple myeloma

Preparing Patients for CAR T-Cell Therapy

While CAR T-cell therapy is a promising treatment, it is also a complex, lengthy process with the risk of serious side effects. It is important that you and your patients understand:

  • Once CAR T-cell therapy is determined to be appropriate treatment, we collect the patient's T cells through leukapheresis. The T cells are then sent to a lab, either at Dana-Farber or off-site, to be engineered to express the target specific for the patient's cancer. This manufacturing process generally takes two to three weeks.
  • Patients may receive lymphodepleting chemotherapy in the days prior to their CAR T-cell infusion, to make room in their immune system for the CAR T cells to expand and proliferate.
  • Most patients are hospitalized for one to three weeks to monitor for side effects. Some patients may receive their CAR T cells in the outpatient clinic and be monitored for 14 days in the outpatient setting.
  • Potential serious side effects may include fevers, chills, low blood pressure, difficulty breathing, confusion, difficulty speaking or understanding language, or stupor. Our teams are specially trained to address these side effects, though patients may be quite ill for a period of time while in the hospital.
  • Patients must remain within two hours of Dana-Farber Brigham Cancer Center for 30 days after their CAR T-cell infusion for rapid management of side effects after discharge. A caregiver is required to stay with the patient during this period.

Our team works collaboratively with referring oncologists after CAR T-cell therapy. We provide guidance on what to watch for, and recommended follow-up care. To monitor the long-term effectiveness of CAR T-cell therapy, patients will require follow-up care for up to 15 years.

International Patients

For international patients who require complex and advanced care such as stem cell transplantation, we offer exceptional medical care and support services, including:

  • Remote consults and online second opinions to evaluate a diagnosis or recommended treatment plans/options
  • Access to the latest diagnostics, such as molecular and genomic profiling, including the Rapid Heme Panel, which was developed by our scientists to rapidly detect key mutations that are important for developing timely treatment plans.
  • Assistance with travel, housing, transportation and other logistics, such as travel visas, medical records transfer, financial estimates, and billing
  • Patient navigators who accompany patients to appointments
  • Interpreter services
  • Extensive patient education materials in print, online, and video formats, many of which are translated for non-English speaking patients and caregivers
  • Nutrition services, with attention to special dietary needs
  • Dedicated social work resources
  • Post-treatment care, consultation, and coordination with physicians, sharing post-discharge care guidelines that outline recommended testing, symptoms to monitor, re-immunizations, and more – all to help you care for your returning patients
  • Learn more about our services for international patients