TREATMENT TIMELINE
Successful completion of CAR T-cell therapy means staying on top of any tests and follow-up appointments your doctor recommends. Here’s what the full treatment schedule may look like:
Day 1: T-Cell Collection Day
The leukapheresis process lasts about two to four hours.
Day 2 to Week 4: Manufacturing and Bridging Therapy
Your T cells will be sent to a lab, where they’ll be genetically modified to fight cancer cells. This can take three to six weeks. Your doctor may prescribe bridging therapy (a short course of chemotherapy or radiation) to control cancer growth during this period.
Week 4: Conditioning Chemotherapy and CAR T-Cell Infusion Day
Before the CAR T cells are infused back into your blood, you must have conditioning chemotherapy. This mild treatment helps suppress the immune system to make space in the body for the CAR T cells to fight the lymphoma. A few days after the chemotherapy, you’ll receive the final CAR T-cell infusion, delivered directly into your body through a vein via an IV.
Weeks 5 and 6: Initial Monitoring
Following the infusion, you’ll be thoroughly monitored for at least seven days. “There’s a requirement for you to stay in the proximity of the medical center for two weeks after your CAR T-cell infusion to monitor for toxicities,” says Dr. Reidel.
Weeks 7 and 8: Continued Monitoring
Your caregiver will continue closely monitoring for any delayed side effects, which can appear up to 30 days after the infusion. You’ll have frequent outpatient visits and tests to determine how effective the treatment is initially. If the treatment is working, you should begin to notice improved energy and well-being. “CAR T cells can remain in the body for months,” says Dr. Sica. “So, while most people see effects by day 30, some still show high, favorable levels at three months and beyond.”
Month 7: Follow-Up Testing Round 1
Approximately 100 days after the infusion, you’ll see your doctor for a major checkup, which includes key scans and tests to formally assess the success of the CAR T-cell therapy and confirm the status of the lymphoma.
Month 13: Follow-Up Testing Round 2
One year after the CAR T-cell infusion is a significant marker. You’ll undergo another critical round of testing, including scans and blood work, to confirm whether the cancer is in long-term remission (meaning the signs and symptoms of the cancer are gone or under control). If not, your provider may recommend a second round of CAR T-cell therapy, especially if you experienced a rapid decline in CAR T cells during the first treatment course.
