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Fly if no toxicity, counts acceptable."},"follow_up_visits":[{"purpose":"assessment","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Frequent early monitoring for cytokine release syndrome and neurotoxicity if discharged"}},{"purpose":"result_review","requirement":"routine","after":{"min":28,"max":35,"unit":"days","qualifier":"First response assessment, about day 28-35 after infusion"}},{"purpose":"result_review","requirement":"routine","after":{"min":85,"max":100,"unit":"days","qualifier":"Response reassessment about day 85-100 (around 3 months) after infusion"}}],"indications":["Relapsed or refractory large B-cell lymphoma","Relapsed or refractory B-cell acute lymphoblastic leukemia","Relapsed or refractory follicular and mantle cell lymphoma","Relapsed or refractory multiple myeloma (BCMA-directed)","Relapsed or refractory chronic lymphocytic leukemia"],"main_risks":["Cytokine release syndrome","Immune effector cell-associated neurotoxicity syndrome","Prolonged cytopenias","Infections and hypogammaglobulinemia","B-cell aplasia","Hemophagocytic lymphohistiocytic-like syndrome","Secondary T-cell malignancies (rare)","Tumor lysis syndrome","Infusion-related hypersensitivity reactions"],"pain":"The infusion itself is generally painless; fever, headache, body aches and malaise may occur with cytokine release, and leukapheresis involves line placement with mild discomfort.","preparation":["Specialist eligibility assessment and disease staging","Infection screening and organ function evaluation","Leukapheresis to collect the patient's T cells","Possible bridging therapy while the cells are manufactured (weeks)","Lymphodepleting chemotherapy a few days before infusion","Central venous access as needed","Arrange nearby accommodation and a caregiver after infusion","Confirm target antigen (e.g., CD19, BCMA) and prior-therapy eligibility","Pre-infusion premedication (paracetamol and antihistamine)","Access to tocilizumab and ICU-level support before infusion"],"recovery_timeline":[{"phase":"Infusion and first 1-2 weeks","description":"Single IV infusion followed by close monitoring for cytokine release syndrome and neurotoxicity, usually peaking in the first 1-2 weeks.","restrictions":["Stay near the treatment center"]},{"phase":"Weeks 2-4","description":"Discharge when stable, frequent visits, blood count and infection monitoring, first response assessment around day 28.","restrictions":["Stay near the treatment center until about day 28","No driving for at least 8 weeks","Avoid crowds and infection exposure"]},{"phase":"Months 2-12","description":"Gradual recovery of blood counts and energy, immune function monitoring, immunoglobulin replacement if needed, response reassessment.","restrictions":["Delay live vaccines per specialist advice"]}],"rehabilitation_days":{"min":60,"max":90,"unit":"days","qualifier":"Functional recovery after the 4-week monitoring period; slower with persistent fatigue, cytopenias, neurotoxicity or infections."},"result_longevity":"In large B-cell lymphoma, about 40% remain progression-free at 1 year; some stay in long-term remission. In B-ALL, about 36% relapse; CAR T cells can persist up to about 5 years.","revision_rate_pct":null,"scars":"There is no surgical incision, only small puncture marks from the leukapheresis or central venous line sites.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One CAR T-cell infusion; leukapheresis and lymphodepletion are preceding stages."},"stages":[{"code":"leukapheresis","label":"Leukapheresis to collect T cells","after":{"min":0,"max":0,"unit":"days","qualifier":"Starting point of the treatment pathway"}},{"code":"lymphodepletion","label":"Lymphodepleting chemotherapy","after":{"min":23,"max":58,"unit":"days","qualifier":"About 3-8 weeks after leukapheresis; 2-5 days before infusion"}},{"code":"car_t_infusion","label":"CAR T-cell infusion","after":{"min":28,"max":63,"unit":"days","qualifier":"Depends on manufacturing and product release time"}}],"qualifier":"Single-infusion therapy; timelines vary by product and center."},"success":{"metric":"Complete response rate in relapsed/refractory large B-cell lymphoma (3rd-line or later)","value":51,"unit":"percent","horizon":"Best response, typically assessed at 1-3 months after infusion","evidence_status":"limited","population":"Adults with relapsed/refractory LBCL after two or more prior lines"},"techniques":[{"name":"Autologous CD19-directed CAR T-cell therapy","suits_whom":"Relapsed/refractory B-cell lymphomas and B-ALL","recovery":"Inpatient monitoring about 10-21 days, then nearby follow-up to day 28."},{"name":"Autologous BCMA-directed CAR T-cell therapy","suits_whom":"Relapsed/refractory multiple myeloma after multiple prior lines","recovery":"Similar monitoring; prolonged cytopenias are common."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":0.5,"max":1,"unit":"hours","qualifier":"Duration of the single CAR T-cell infusion itself; leukapheresis (about 3-6 hours) and lymphodepletion are separate."},"initial_assessment_documents":["Pathology report with CD19 or BCMA status","Summary of prior treatment lines and responses","Recent PET-CT or MRI report","Bone marrow biopsy report","Recent CBC, kidney and liver function tests","Echocardiogram report (if available)"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Cell collection, then 3-9 weeks manufacturing, usually at home; return for infusion and 4+ weeks nearby. One trip means staying."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask the clinic for examples of the practitioners' experience with the exact procedure you are planning","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Ask for examples of the practitioners’ experience with the surgery you are intending to have.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Ask whether a doctor is always present in the clinic and whether a high dependency or intensive care unit exists","scope":"treatment_abroad","source":{"url":"https://www.bapras.org.uk/public/patient-information/cosmetic-surgery/cosmetic-surgery-abroad","host":"bapras.org.uk","quote":"Is there always a doctor in the clinic and is there a high dependency or intensive care 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