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Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage)
CPT4 code
Name of the Procedure:
Chimeric Antigen Receptor T-Cell (CAR-T) Therapy; Preparation of Blood-Derived T Lymphocytes for Transportation (Cryopreservation and Storage)
Summary
The process involves collecting T lymphocytes (a type of white blood cell) from a patient's blood and preparing them for transportation by freezing (cryopreservation) and storing them until needed for CAR-T therapy.
Purpose
This preparation is essential for CAR-T therapy, a treatment aimed at some types of cancer. The goal is to modify the patient's T cells to target and destroy cancer cells.
Indications
- Certain types of cancer, such as B-cell acute lymphoblastic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL)
- Patients who have not responded to other treatments or have relapsed
Preparation
- Patients may need to undergo blood tests and imaging studies to assess overall health and eligibility.
- No special preparation like fasting is typically required for the initial blood collection.
Procedure Description
- Blood Collection: Blood is drawn from the patient, usually through a vein in the arm.
- T-Cell Isolation: T lymphocytes are separated from the rest of the blood components.
- Cryopreservation: The isolated T cells are mixed with a cryoprotectant to prevent cell damage and then gradually frozen.
- Storage: The frozen cells are stored in a controlled environment until they are ready to be transported to the lab for modification and expansion.
Duration
The preparation process, including blood collection and cryopreservation, typically takes a few hours.
Setting
The procedure is usually performed in a hospital or specialized outpatient clinic.
Personnel
- Hematologists or oncologists
- Specialized nurses or technicians
- Lab personnel handling cryopreservation and storage
Risks and Complications
- Risk of infection from the blood draw
- Potential allergic reaction to cryoprotectants (very rare)
- Cells may not survive the freezing and thawing process (rare but possible)
Benefits
- Enables the subsequent CAR-T therapy, which can provide significant improvement or remission in certain cancers.
- The cryopreservation process allows flexibility in timing for the therapy.
Recovery
- Minimal recovery time is needed after the blood draw.
- Patients may resume normal activities shortly after the procedure.
Alternatives
- Other forms of immunotherapy or targeted therapy
- Bone marrow or stem cell transplantation
- Chemotherapy or radiation therapy Pros and cons of each alternative should be discussed with healthcare providers.
Patient Experience
- Mild discomfort during blood draw similar to standard blood tests.
- Patients may feel relieved knowing their cells are preserved and ready for potentially life-saving treatment.
- No significant pain management is generally required for this process.