CAR-T CELL THERAPY FOR
LEUKEMIA

CAR-T (Chimeric Antigen Receptor T-cell) therapy engineers the patient's own immune cells to recognise and destroy leukaemia cells. T-cells are extracted, genetically modified to express a receptor targeting leukemic antigens (CD19, CD22, or BCMA), then infused back — creating a living drug that persists and multiplies in the body.

“CAR-T is not a drug you take — it is a one-time living therapy that hunts residual disease.”

• How It Works

  Patient T-cells are collected via leukapheresis, engineered in the lab to express a cancer-targeting receptor, expanded into hundreds of millions of cells, then infused after lymphodepletion chemotherapy. The modified cells multiply and attack CD19/CD22/BCMA-expressing leukaemia cells.

• Targets in Leukemia

  CD19 is the dominant target in B-ALL and CLL. CD22 is used when CD19-negative relapse occurs. Bispecific CAR-T products targeting both CD19 and CD22 simultaneously reduce antigen-escape relapse risk — a major advance available in China trials.

• 81-94%Complete remission rate in r/r B-ALL (major China and US trials)
• 600+Active CAR-T clinical trials in China — more than USA + Europe combined
• 40-70%Lower cost for NMPA-approved CAR-T vs US list prices
• $0Drug cost for trial-enrolled patients (travel/support costs apply)
• 98%MRD-Negative Rate Among Responders (Adult B-ALL, ZUMA-3)In long-term ZUMA-3 follow-up, measurable residual disease negativity was extremely high among responders, showing that CAR-T can induce very deep remissions, not just morphologic remission.
• 25.6 monthMedian Overall Survival (Adult r/r B-ALL, ZUMA-3)Updated adult B-ALL data showed median overall survival of 25.6 months, which is a strong survival benchmark in a heavily pretreated relapsed/refractory setting.

CAR-T therapy has demonstrated the strongest results in B-cell leukaemias. Response rates and approved products differ significantly by subtype.

• B-ALL (B-cell Acute Lymphoblastic Leukaemia)

  Strongest evidence base. CD19-targeted CAR-T (e.g. axicabtagene, tisagenlecleucel, relmacabtagene) delivers 81-94% CR in r/r adult and paediatric B-ALL. Bispecific CD19/CD22 products available in China trials reduce CD19-loss relapse.

• CLL (Chronic Lymphocytic Leukaemia)

  CD19-targeted CAR-T achieves 40-60% overall response in heavily pretreated CLL, with durable remissions in a subset. Ibrutinib pretreatment improves CAR-T expansion and response. China trials are evaluating CD19/CD22 bispecific designs in CLL.

• AML (Acute Myeloid Leukaemia)

  No globally approved CAR-T product yet. Active China trials target CD33, CD123, CLL-1, and NKG2D ligands. CR rates of 30-60% in early-phase trials. Allogeneic off-the-shelf CAR-T programmes are in Phase I/II — accessible to patients today through trial enrollment.

• T-ALL / T-cell Leukemias

  More challenging due to shared antigens between CAR-T cells and T-leukaemia cells (fratricide). CD7 and CD5-targeted strategies are in early trials in China. Allogeneic approaches reduce fratricide risk and are progressing.

1. 1

   Step 1: Eligibility Assessment

   CancerFax reviews your diagnosis, prior treatment history, CD19/CD22 expression, and performance status. We identify whether commercial product or trial enrollment is more appropriate.

2. 2

   Step 2: Travel to China

   Patients travel to a partner hospital in Beijing, Shanghai, or Guangzhou. CancerFax coordinates medical visa, accommodation, interpreter, and hospital admission.

3. 3

   Step 3: Leukapheresis (T-cell Collection)

   T-cells are collected via a 3-4 hour apheresis procedure. No surgery, no anaesthesia. Cells are shipped to the manufacturing facility.

4. 4

   Step 4: CAR-T Manufacturing

   The CAR-T product is manufactured over 2-4 weeks. The patient may continue bridging chemotherapy during this period to control disease.

5. 5

   Step 5: Lymphodepletion Chemotherapy

   Fludarabine and cyclophosphamide conditioning (3 days) depletes existing lymphocytes to create space for CAR-T expansion.

6. 6

   Step 6: CAR-T Infusion

   The CAR-T product is infused intravenously over 30-60 minutes. Inpatient monitoring begins immediately for cytokine release syndrome (CRS) and neurotoxicity (ICANS).

7. 7

   Step 7: Monitoring and Response Assessment

   Inpatient for 14-28 days post-infusion. Bone marrow assessment at Day 28 and Day 90 confirms remission. MRD-negative CR is the primary goal.

China's CAR-T landscape is the most advanced globally by trial volume. Key differences affect both access and cost.

CAR-T therapy carries significant but manageable toxicities. All are monitored in the inpatient setting with established grading and management protocols.

• Cytokine Release Syndrome (CRS)

  Occurs in 50-90% of patients, usually within 1-14 days of infusion. Ranges from fever and fatigue (Grade 1-2) to hypotension and hypoxia (Grade 3-4). Tocilizumab (anti-IL-6) reverses Grade 3-4 CRS rapidly. Grade 5 CRS is rare at experienced centres.

• ICANS (Immune Effector Cell-Associated Neurotoxicity)

  Confusion, speech difficulty, tremor, or seizure in 10-40% of patients. Typically peaks 5-14 days post-infusion. Corticosteroids are the primary treatment. Fully reversible in most cases.

• Prolonged Cytopenias and Infection Risk

  CAR-T depletes both malignant and normal B-cells, causing hypogammaglobulinaemia and increased infection risk for months. IVIG supplementation and antimicrobial prophylaxis are standard.

Frequently Asked Questions