What is CAR T-cell therapy?

CAR T-cell therapy works by taking some T cells (blood cells that help to protect you from infection and disease) out of your blood, genetically modifying them in a lab so they are much better at finding and killing cancer cells, and then putting them back into your blood to fight the cancer. 

There are several stages in the process of having CAR T-cell therapy, which takes several weeks:

• T cells are taken from your blood, using a tube inserted into a vein in your arm. This takes two to three hours.
• T cells are taken to a laboratory and genetically modified, turning them into CAR T-cells. This takes two to three weeks.
• CAR T-cells are put back into your bloodstream, through a drip. This takes a few hours.
• CAR T-cells attack and kill cancer cells in the body. You will be closely monitored after having CAR T-therapy. 

Find out more about having CAR T-cell therapy.

Updated 25 November 2024

In the UK, people with the following types of blood cancer may be able to have CAR-T cell therapy, if they meet certain conditions. In many cases, CAR T-cell therapy needs to be given through the Cancer Drugs Fund or another patient access scheme.

B-cell acute lymphoblastic leukaemia (ALL)

For children and adults with B-cell ALL, CAR T-cell therapy can be given if treatment has not worked, or the ALL has come back after treatment.

Diffuse large B-cell lymphoma (DLBCL)

For adults with DLBCL, CAR T-cell therapy can be given if any of these things apply:

• the lymphoma has continued to grow after at least two treatments
• the lymphoma has returned within a year of a first treatment with chemoimmunotherapy
• the lymphoma is resistant to first treatment with chemoimmunotherapy.

High-grade B-cell lymphoma (HGBL)

In some areas of the UK, CAR T-cell therapy may be available to people with types of high-grade B-cell lymphoma, if the lymphoma has returned within a year of a first treatment with chemoimmunotherapy, or it is resistant to first treatment with chemoimmunotherapy.

Mantle cell lymphoma

For adults with mantle cell lymphoma, CAR T-cell therapy can be given if the lymphoma has continued to grow after two prior treatments including a Bruton’s tyrosine kinase (BTK) inhibitor such as ibrutinib.

Primary mediastinal large B-cell lymphoma (PMBCL)

For adults with PMBCL, CAR T-cell therapy can be given if the lymphoma has continued to grow after at least two treatments.

Unfortunately not. Right now, CAR T-cell therapy is only a treatment option for certain blood cancers that haven’t responded to other standard treatments. There is also a high risk of side effects, so the person must have a certain level of fitness at the time of treatment.

If you think you may be eligible for CAR T-cell therapy and want to find out more, speak to your healthcare team.

If you are eligible, your doctor will refer you to both a local and a national CAR-T panel. The panel prioritises people eligible for CAR T-cell based on their fitness and severity of the cancer. 

There are currently three types of CAR T-cell therapy being used in the UK, made by two different companies. They are called:

• Kymriah (tisagenlecleucel)
• Yescarta (axicabtagene ciloleucel)
• Tecartus (brexucabtagene autoleucel).

The CAR-T treatments approved for use in the UK have been through rigorous trials to make sure they’re as safe as possible for eligible patients. However, CAR T-cell therapy is still a new treatment and we’re learning with each clinical trial how to make it more effective. 

As with all cancer treatments, there are benefits and risks. As CAR T-cell is a new treatment, we don’t yet know if there are any longer-term risks. 

CAR T-cell therapy is still new and can cause some serious side effects. This is why the treatment is only done in specialist hospitals that have an expert team to manage these if they do occur.

Read more about possible side effects of CAR T-cell therapy.

The CAR-T treatments being used in the UK have been shown to be better at getting people into remission than existing treatments. However, the evidence is still limited to the trials that have been done with specific groups of patients. We don’t know how well CAR T-cell therapy works in large numbers of people, and we don’t know how well it works in many types and stages of blood cancer.  

Because CAR T-cell therapy is a new treatment, we also don’t know what the longer-term impact is, in terms of response, survival and side effects.   

In addition to the CAR-T treatments explained here, which are now being used on the NHS, there are multiple other CAR-T treatments still being researched in clinical trials. They are looking at how to use CAR T-cell therapy to treat leukaemias, lymphomas and myeloma.  

If you want to know more about clinical trials you may be eligible for, speak to your healthcare team. 

For help understanding and accessing clinical trials, contact our Clinical Trials Support Service.

We’re funding clinical trials into CAR-T so we can develop the treatment and make it available to more people. 

We supported the appraisal process for the new CAR-T treatments, helping to get them approved for use on the NHS for people with blood cancer.  

Now that some CAR T-cell therapies are being rolled out, we’re monitoring uptake closely, speaking to people who’ve had the treatment and the clinicians involved in their care. We want to understand how effectively it’s working and whether there are things that need to change to improve peoples’ experiences in future. 

Read more about our research impact.

Thank you to Professor Karl Peggs for working with us to produce the written content on this page.

Professor Peggs is Scientific Director of the National Institute for Health Research (NIHR) Blood and Transplant Research Unit in Stem Cells and Immunotherapies, and Medical and Scientific Director of the Sir Naim Dangoor Centre for Cellular Immunotherapy at UCLH.

CAR-T information review

Throughout 2024, Blood Cancer UK is reviewing its CAR-T information and expanding the resources available for healthcare professionals and the blood cancer community. This work is being funded by Autolus Therapeutics Ltd and Beefy's Charity Foundation. These organisations provided funding but had no further input.