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Professor John G Gribben
Professor Gribben specialises in haematological cancers including lymphomas, leukaemias and bone marrow transplantation.
Our team of renowned Haematologists have expertise in all aspects of haematology.
We work closely with world-leading oncology consultants, supported by some of the most modern treatment technology available.
This treatment has been making news around the world. In June 2019, The London Clinic was featured in:
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The London Clinic offers this transformative cell therapy to cancer patients. CAR-T cell therapy is a cutting-edge treatment for adults with diffuse large B-cell lymphoma. Immune cells are collected from patients and genetically modified to destroy cancer cells. This revolutionary therapy can offer hope for people who have no other treatment options.
Blood cancers like lymphoma are the third biggest cancer killer in the UK. The London Clinic has world-leading oncology and haematology consultants offering the very latest treatments for cancer. The Clinic’s priority is to provide the very best cancer care and support in a comfortable, stress-free environment.
Why choose The London Clinic?
The London Clinic is dedicated to providing the best, personalised healthcare with over 600 world-renowned consultants available to offer informed health advice and treatment.
Spanning Harley Street and Devonshire Place, The London Clinic is situated in the heart of London’s internationally-known medical district. This central location, together with state-of-the art technologies and facilities that are not widely available in other hospitals, makes The London Clinic the hospital of choice for around 120,000 patients every year.
Offering affordable and competitive self-pay packages and expert support from Clinical Nurse Specialists and our specialised multidisciplinary team, over 98% of our patients said they would recommend The London Clinic to their friends and families.
What cancer can CAR-T treat?
CAR-T is used in the treatment of some types of the blood cancer Non-Hodgkin lymphoma. The cancer develops in white blood cells known as lymphocytes, which play an important part in the immune system, fighting abnormal cells and infections.
The London Clinic offers CAR-T therapy for an aggressive type of Non-Hodgkin lymphoma which develops in lymphocytes known as B-cells - diffuse large B-cell Lymphoma.
Immune T-cells usually seek out and kill abnormal cells in the body. However, the cancerous B-cells can hide from the immune system, allowing them to grow and divide rapidly and uncontrollably.
What is CAR-T Immunotherapy?
CAR-T is a totally new type of cancer therapy. CAR-T stands for chimeric antigen receptor T-cell. The therapy, known as YESCARTA® is a complex and innovative treatment using the body’s own cells to fight the cancer.
The therapy is individually developed for each person. T-cells are collected and genetically reprogrammed so that they can be reintroduced into the body to target and attack lymphoma cells.
Research trials show that CAR-T can have a positive outcome for people with diffuse large B-cell Lymphoma.
‘CAR-T cell therapy is an exciting advancement in the treatment of blood cancers, offering a new, final treatment option for patients when others haven’t had the result they need from conventional chemotherapy.
‘Diffuse large B-cell lymphoma is an aggressive form of blood cancer. So far, this treatment is showing promising outcomes for many patients, letting them return to normal lives with their families and loved-ones. The London Clinic is a pioneering hospital and we are proud to offer this treatment to our patients.’Professor John GribbenCART-T treatment leader at The London Clinic
How does CAR-T therapy work?
T-cells are an important part of the body’s natural protection against disease. They fight infection by finding bacteria and viruses and killing them. However T-cells also have the ability to destroy other abnormal cells, like cancer cells, it is this ability which is used in CAR-T therapy.
The abnormal B lymphocytes in lymphoma can hide from T-cell attack.
However, T-cells can be removed from the body and genetically modified so that they are more effective at recognising and killing specific cancer cells.
The reprogrammed T-cells are infused into the body, where they circulate in the blood and attack any target cancer cells they come across. They release chemicals called cytokines that signal to other cells to join the attack. The immune system learns to recognise and kill cancer cells.
Unlike chemotherapy and other cancer treatments, CAR-T cells stay in the body and remain active for a long time. This means the treatment to be given as a one-off and the effects of therapy are ongoing.
Who can have CAR-T therapy?
CAR-T therapy is not a first line treatment for lymphoma. So far it has only been NICE approved for people with advanced disease and limited treatment options. At The London Clinic, YESCARTA® is used in adults to treat diffuse large B-cell Lymphoma, when at least two other previous treatments have stopped working.
What does the treatment involve?
The treatment occurs in several stages, over a number of weeks. CAR-T therapy at The London Clinic is carried out as a series of day admissions, in the comfort and privacy of the Duchess of Devonshire Wing. Throughout your treatment, your specialist cell therapy team will be there to help, advise you of side effects, and support you every step of the way.
- Leukapheresis: The first step involves blood being taken, filtered and the T-cells extracted on the spot. This procedure can take between three and six hours and we will make sure that the time spent at our facility will be as relaxing and enjoyable as possible.
- CAR-T manufacturing: The blood is sent to a specialist laboratory, where the T-cells are genetically modified to boost their ability to fight cancer cells. The process takes around three to four weeks, then the blood containing the genetically engineered T-cells is returned to The London Clinic.
- Lympho-depleting Chemotherapy: You will be given three days of chemotherapy to reduce the number of normal T-cells in the system. This is usually given through a central line and overnight admission is often not necessary. The dose will be lower than other chemotherapy you may have been given during the treatment of your cancer, however it could still cause nausea, hair-loss, infections and other side-effects.
- YESCARTA infusion: The blood containing the boosted T-cells will be reinfused into your blood stream through a drip over around half an hour.
- Daily monitoring period: The London Clinic cell therapy team will monitor you every day for at least ten days and discuss housing arrangements and support requirements tailored to our specific needs.
- Follow-up period: You will have follow-up appointments to examine you, performs blood tests as necessary and help you with any side effects. If necessary, we would schedule a weekly phone call with you. You will also be given a number to call in case you have any side effects, an alert card to show to any health professionals you see, and instructions on what to do if you are unwell.
- Post-treatment reassessment: after your treatment we will schedule in further appointments to assess how effective the treatment was for you. You may undergo assessments such as positron emission tomography (PET) scans or computerised tomography (CT) scans.
Treatment risks and recovery
There are risks and side effects with any treatment. Your consultant will carefully take you through the dangers and benefits of treatment, so that you can make an informed choice about your care.
CAR-T immunotherapy can trigger serious side-effects which usually come on within five days of the infusion. Cytokine release syndrome (CRS) can happen when the T-cells first meet cancer cells and release high levels of cytokines. This can trigger flu-like symptoms like fever, chills, breathlessness, faintness, heart racing and difficulty breathing.
Neurologic side effects are common affecting two thirds of people. Headaches, confusion, problems with speech and communication and drowsiness are all recognised features.
The side-effects sound frightening, but in almost all cases they resolve completely over a few days or weeks. Your specialist team at the London Clinic is familiar with these reactions and will offer support and care to help you manage any reactions you may experience. One in ten people suffer the severe form of CRS and may need intensive care treatment to ensure they are supported as they recover.
When your treatment is complete, the specialist team at the London Clinic will arrange follow-up appointments to monitor your progress and assess the effectiveness of the treatment. They may schedule investigations in the Clinic’s state-of-the-art imaging suite. PET or CT scans can help your cell therapy team see how well the lymphoma is responding to treatment.
CAR-T therapy cost
Cancer care at The London Clinic may be covered by insurance. Please call +44 (0)203 219 3315 and speak to our helpful team to find out more about CAR-T therapy and to book an appointment or email firstname.lastname@example.org.
The London Clinic offers affordable, competitive self-pay packages for certain treatments.
Patients have the option to spread the cost of treatment with Chrysalis Finance.
Please call +44 (0)20 3613 7502 to speak to our helpful team to find out more and to book an appointment.
General enquiries: 020 7935 4444 Appointments: 020 7616 7693 Self-Pay: 020 3219 3315
Your call may be recorded for training and monitoring purposes.