Preventing and treating infections in patients with blood cancer following CAR-T cell therapy

Blood cancer can stop the immune system from working properly. This means people with blood cancer are more vulnerable to illnesses and infections. Many blood cancer treatments can also temporarily weaken the immune system.

CAR-T cell therapy is a promising type of cancer treatment for many people with blood cancer that harnesses the power of the immune system to destroy cancer cells. This treatment involves taking T-cells (cells that help to protect you from infection and disease) from a patients’ own blood, modifying them in a lab and then giving them back to the patient to seek out and destroy the cancer.

Unfortunately, some people develop infections following this type of treatment. As this type of treatment is still relatively new, we don’t understand who is most at risk of these types of infection and the best way to prevent and treat this when it arises. Antibiotic resistance following infection is becoming more common, which makes it harder to choose the right antibiotics for each patient. Since infections can be very serious for people with blood cancer, we desperately need to finding better ways to prevent, detect, and treat infections in these patients in a way that’s more tailored to each person’s needs.

In this project, Dr Hamilton and his research team at University of Cambridge will study 100 adults receiving CAR-T cell therapy at hospitals in Cambridge, Birmingham, and Oxford. They want to understand more about the infections these patients develop after CAR-T treatment and how they are treated. To do this they will examine which bacteria or viruses are causing infections, identifying which patients are most at risk to ensure they can get the right preventative care. They will also examine how bacteria become resistant to antibiotics in patients following CAR-T cell therapy and whether this differs from other people with blood cancer. Taking this one step further, they will explore how the natural bacteria living in the body (the microbiome) change during and after treatment, how this might affect infection risk and how patients become resistant to antibiotics.

If successful, this project could help to improve how infections are managed in blood cancer patients following CAR-T cell therapy. It could help develop better guidance for healthcare professionals following treatment which ultimately has the potential to save lives. This research could also pave the way for a more personalised approach treatment in the future where treatments are altered, or new treatments are developed in line with the patient’s microbiome to prevent and treat infections.