Adoptive Cell Therapy

Adoptive cell therapy is a type of immunotherapy. It is mainly used for treating cancer. A special variety of immune cells called T cells is introduced into the body of a cancer patient. These T cells are usually drawn from the blood or fast-growing cancerous tissues of that patient. Then these cells may be further treated in the laboratory before transferring back into the person’s body to stop the spread of cancer.

Alternate Name:

T cell transfer therapy, adoptive immunotherapy, or immune cell therapy

Body Location:

Cancerous tumour on any part of the body

Procedure Type of Adoptive Cell Therapy:

Adoptive cell therapy can be of 2 types, namely Tumour Infiltrating Lymphocyte (TIL) therapy and Chimeric Antigen Receptor T cell (CART) therapy.

Preparation for Adoptive Cell Therapy:

Adoptive cell therapy can be conducted only in a cancer centre. The patient needs to have a prior appointment and arrive at the scheduled time to this centre. It is better to bring a person accompanying the patient, as the aftereffect of this treatment can be different for different patients. A course of lymphodepletion is imparted to the patient before T cell therapy, to ensure positive responses of this treatment. Different types of blood tests are done before starting the adoptive cell therapy procedure, to know the health condition of the patient. 

The types of blood tests depend on the type of immunotherapy chosen by the doctor. The patient should show all the medications that he/she is currently taking, to the attending doctor or pharmacist of the cancer centre. No specific diet is recommended to the patient before undergoing adoptive cell therapy.

How is Adoptive Cell Therapy Performed 

Some immune cells are collected from the body of the patient by drawing blood from the cancerous part. Sometimes, a catheter is inserted into a vein under the collarbone to draw blood from the patient’s body. White blood cells are extracted from the blood after which the red blood cells and plasma can be returned to the body through a process called Leukapheresis. These T cells are cultured and artificially multiplied in numbers in the laboratory. 

This laboratory process may continue for 2 – 8 weeks, depending on various factors. The patients can take chemotherapy or radiation during this period to reduce the severity of their disease. As the number of immune cells decreases due to this cancer treatment, it becomes easier for cultured immune cells to function immediately in the patient's body. When the biological process in the laboratory is over, this large number of immune cells can be pushed back into the patient's body. An injection syringe is used to deliver the cultured immune cells back into the patient's vein.

Follow up:

Since cancer patients are already in a serious health condition, follow-up care after adoptive cell therapy is very important. The minimum recovery period after this therapy is 30 days, which can extend to 2 – 3 months. The patient should have a caregiver all the time who can monitor all signs of side effects and report immediately to the attending doctor. Most patients feel too tired and may experience nausea, loss of appetite, fever, an infection, or even neurological problems. Thus, the patient should stay in a hospital or healthcare centre, preferably near the centre where he/she received adoptive cell therapy treatment.

Risks of Adoptive Cell Therapy:

The sudden increase in the number of immune cells in the body can cause one or more of the following side effects. Mild or severe Cytokine release syndrome Fever Headache Nausea Diarrhoea Joint and muscle pain Rashes Faster heartbeat Drop in blood pressure Breathing problem Occasional seizure

Recovery of Adoptive Cell Therapy:

Sometimes, these above-mentioned side effects can be life-threatening for a cancer patient. So, a healthcare provider should be with him/her for 24 hours, to check his/her health conditions from time to time. Generally, the recovery period lasts for 2 months when the patient can go through several side effects of adoptive cell therapy. However, the patient should stay in the hospital for the first month, as side effects can be stronger at that time. The patient may feel agitated without any valid reason and show tantrums, which should be dealt carefully by the caregiver. The patient should avoid all physical activities during the first few weeks after receiving this therapy. Some patients also face difficulty in speaking due to the effect of immune cells, which increases the responsibility of their caregivers in understanding their problems.