are blood tests that check blood, kidney, and liver function to ensure you’re a good candidate for CAR T-cell therapy.
Complete blood count and organ function labs
uses CT/PET scans to look at the state of the lymphoma before your T cells are collected.
Disease status evaluation
is a type of ultrasound that checks your heart’s structure and function to ensure it can handle the stress of leukapheresis.
Echocardiogram
Practical Preparation
Tests
Most treatment centers ask that a caregiver stay with you throughout the process, from T-cell collection through the 30 days after infusion. A caregiver can drive you to and from appointments (which you’re not allowed to do yourself during this period, due to the therapy’s risk of neurological side effects), help with physical tasks, and provide emotional support. Consider having a backup in case your primary caregiver gets sick or is otherwise unavailable.
Line up a caregiver.
CAR T-cell therapy is often covered by private insurance and Medicare. Your care team will submit the request and can give you a sense of when you may hear back or should follow up. On average, approval takes 10 days to 4 weeks.
Check your insurance.
Procedure Preparation
involves blood, saliva, and/or urine tests to detect infections that could weaken your immune system and make treatment riskier.
are breathing tests to measure how well your lungs move air and deliver oxygen, to make sure there are no issues during treatment.
Pulmonary function tests
Infectious disease screening
Patient advocacy groups and CAR T-cell therapy manufacturers may offer programs to help cover travel, lodging, or other treatment-related costs.
Ask about financial support.
Review your medications and learn about the potential side effects of CAR T-cell therapy with your team. Because the therapy can temporarily weaken your immune system, your doctor may create a vaccine schedule for you to follow during and/or after treatment to rebuild your immunity. Even vaccines you received when you were younger may no longer provide full protection, says Roberto Alejandro Sica, MD, a medical oncologist and assistant professor of medicine at Albert Einstein College of Medicine in the Bronx, New York.
Meet with your oncologist.
If you need to stay near the treatment center, a social worker or nurse navigator can help you find a place to stay.
Arrange travel and lodging.
Be sure to hydrate in the days leading up to the leukapheresis procedure (though you’ll need to restrict fluids the day of). You should also drink a lot of water before and on chemotherapy days.
Manage your fluid intake.
A day or two before T-cell collection, fill your plate with dairy products (such as cheese and yogurt) and leafy greens (such as broccoli and kale) to prevent your calcium levels from dipping during leukapheresis.
Eat calcium-rich foods.
This makes for easy access for IV tubes, drains, and other medical equipment used during the procedure.
Wear comfortable, loose clothing with buttons or a zipper.
Chemotherapy medications suppress your immune system, so it’s important to steer clear of anyone who is ill. This includes your caregiver, making it even more important to have a backup option.
Avoid contact with anyone who is sick.
You might even want to bring your knitting needles or an adult coloring book. You can also ask if your caregiver is allowed to stay with you during appointments to keep you company. And remember to bring headphones.
Bring a book, music, or a tablet for entertainment.
Tell your employer or school about the time off you’ll need for treatment and recovery.
Coordinate a leave of absence.
Make sure your responsibilities at home are covered while you’re going through treatment.
Set up childcare or pet care.
