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Let’s break it down:
In CAR T-cell therapy, your T-cells are removed from your blood and sent to a lab where a scientist adds a CAR to them. This is why they are called CAR T-cells.
The CAR T-cells are then sent back to the hospital and infused back into your blood in a procedure like a blood transfusion. They then move into your lymphatic system and travel around your body, the CAR finds and sticks to the lymphoma cells, and the T-cell destroys them.
Our immune system protects us from infections and diseases, including cancers like lymphoma. It has special cells called white blood cells. These cells move through our blood and lymphatic system to every part of our body, finding and destroying things that don’t belong – like germs or cancer cells.
We have different types of white blood cells, each with a different job, but all protect us from infection and disease. Some of these are called lymphocytes. It is these white blood cells – the lymphocytes, that become cancerous in lymphoma.
Lymphocytes are also very important in CAR T-cell therapy because the T-cells are a type of lymphocyte.
Sometimes, lymphocytes cells stop working properly. They can grow too fast and live longer than they should. When this happens, it can lead to lymphoma, which is a type of cancer.
Lymphoma cells can also trick the immune system. They may hide from it or stop it from working well. That’s when special treatments like CAR T-cell therapy can help.
For a more detailed explanation of how our lymphatic & immune systems work together to protect us see Understanding your lymphatic & immune systems – Lymphoma Australia.
Lymphoma is often treated with chemotherapy or radiation. These treatments kill fast-growing cells, including lymphoma. But they can also harm healthy cells that grow quickly, like those in your mouth, or stomach and your hair.
Another kind of treatment is called immunotherapy. It helps your immune system find and destroy cancer cells without harming as many healthy ones. CAR T-cell therapy is a type of immunotherapy. Watch the 3-minute video below for an explanation of how CAR T-cells are made and work.
To diagnose lymphoma you will need a biopsy. A biopsy is a procedure to remove part, or all of an affected lymph node and/ or a bone marrow sample. The biopsy is then checked by scientists in a laboratory to see if there are changes that help the doctor diagnose lymphoma.
When you have a biopsy, you may have a local or general anaesthetic. This will depend on the type of biopsy and what part of your body it is taken from. There are different types of biopsies and you may need more than one to get the best sample.
Core or fine needle biopsies are taken to remove a sample of swollen lymph node or tumour to check for signs of lymphoma.
Your doctor will usually use a local anaesthetic to numb the area so you don’t feel any pain during the procedure, but you will be awake during this biopsy. They will then put a needle into the swollen lymph node or lump and remove a sample of tissue.
If your swollen lymph node or lump is deep inside your body the biopsy may be done with the help of ultrasound or specialised x-ray (imaging) guidance.
You might have a general anaesthetic for this (which puts you to sleep for a little while). You may also have a few stitches afterwards.
Core needle biopsies take a bigger sample than a fine needle biopsy.
During this procedure, a surgeon will remove the whole lymph node or lump and send it to pathology for testing. You may have a general anaesthetic which will put you to sleep for a little while, so you stay still and feel no pain.
You will have a small wound with a few stitches, and a dressing over the top.
Stitches usually stay in for 7-10 days, but your doctor or nurse will give you instruction on how to care for the dressing, and when to return to have the stitches out.
Excisional node biopsies are more reliable than fine needle or core needle biopsies for diagnosing lymphoma.
Blood tests are taken when trying to diagnose your lymphoma, but also throughout your treatment to make sure your organs are working properly and can cope with our treatment.
Once your doctor gets the results from you blood tests and biopsies they will be able to tell you if you have lymphoma and may also be able to tell you what subtype of lymphoma you have. They will then want to do more tests to stage and grade your lymphoma.
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To understand lymphoma, you need to know a bit about your B-Cell lymphocytes.
B-Cell lymphocytes:
Lymphoma develops when some of your B-cell lymphocytes (B-cells) become cancerous. They grow uncontrollably, are abnormal, and do not die when they should.
When you have lymphoma your cancerous B-cells:
Some lymphomas grow very quickly, which means the cancerous B-cells are multiplying (making new copies of themselves). Other cancerous B-cells may live longer than they should.. B-cells (and many other cells) are designed to live for a purpose. Once they have achieved that purpose, they naturally die to make room for new stronger healthy B-cells.
In some cases, lymphoma develops when the cancerous B-cells just keep living even when they have no purpose. They then take up too much room which can stop your body making new healthy cells.
Special Note: Although your T-cells are removed from your blood for CAR T-cell therapy, most of our T-cells live outside of our blood – in our lymph nodes, thymus, spleen and other organs.
You need healthy T-cells to make CAR T-cells. For this reason, CAR T-cell therapy cannot be used if you have a T-cell lymphoma – yet.
For more information on CAR T-cells and T-cell lymphoma click here.
Please note:
Lymphoma Australia staff are only able to reply to emails sent in English language.