CAR T Therapy: Preparation and T-cell collection (Leucopheresis)
This information explains the main procedures needed before admission for CAR-T cell therapy. This includes the tests, chemotherapy and process of collecting T cells.
What tests will my child need?
The following give a guide to the tests your child will need. Additional tests may be required based on your child's individual needs. If you have any questions about the tests, please contact your local team, or CAR T specialist nurse.
All children need an Echocardiogram, which is an ultrasound of the heart. It shows the structures, function and blood flow through the heart.
All children will need an ECG, which shows the heart beating, how regularly and all of the electrical activity within the heart.
Glomerular Filtration Rate (GFR) Test
The Glomerular filtration rate (GFR) test is used to show how well your kidneys are working. This is important as some of the chemotherapy used during CAR T cell therapy may be affected by your kidney function.
Computerised Tomogaphy (CT) Scan
A CT scan uses x-rays and computers to take pictures of the internal structures of your child's body. This information is useful to look for any infection disease in the chest and help us treat any infection before and during CAR T cell therapy if needed.
MRI Head and Spine
MRI scans use strong magnetic fields and radio waves to make a picture of the inside of your body. MRI stands for Magnetic Resonance Imaging.
We use MRI scans to look at the brain and spinal cord to help us establish the risk of CAR T related side effects, based on your child's prior therapy and disease status.
Your child will have some blood tests, taken from their central line, in order to safely perform the T cell collection, and the right time.
These tests will be explained to you in detail by your CAR T specialist nurse, prior to them being taken.
T-Cell Collection and Apheresis
After your initial consultation and consent to CAR T cell therapy treatment, your child's T cells will need to be collected in order to make the CAR T cell product, this is commonly known as Leucopheresis.
The creation of CAR T cells begins with collection of the patients blood, and separation of the lymphocytes (which are made up of T cells amongst other immune cells) through leucopheresis.
Your child will have a central line inserted, called a vascath. The following day, they will be connected to the apheresis machine via the vascath, which filters the T cells from the blood.
Once the T cells have been collected in sufficient numbers, the vascath line can be removed and your child can return home, if well.