Today we interview Lori Dear, a registered nurse and transplant coordinator in the adult Blood & Marrow Transplant Program at Corewell Health in Grand Rapids, Michigan. Lori shares her deep insights into the CAR T-cell therapy process, a groundbreaking treatment for certain cancers, focusing on the patient experience and the critical role of caregivers.

Lori explains that CAR T-cell therapy is highly personalized, with no "cookie-cutter" approach. A diverse interdisciplinary team, including physicians, nurses, pharmacists, and various specialists, collaborates to guide patients through the process, from eligibility testing to treatment and recovery. She stresses the importance of preparing for the CAR T process by researching the therapy and arranging for a trustworthy caregiver, who will play a crucial role in managing care for up to 12 weeks after infusion. Lori points out that caregivers often include spouses or close friends, but emphasizes that anyone chosen should be reliable and available 24/7 for an extended period.

Eligibility for CAR T therapy involves various health screenings, including heart, lung, and kidney function tests, to ensure a patient’s fitness for the treatment. The goal is to minimize risks and optimize outcomes. Lori also discusses the importance of being near the treatment center, typically within one to two hours, particularly during the critical post-infusion period.

Side effects like Cytokine Release Syndrome (CRS) and ICANS (neurotoxicity) are potential complications, and caregivers play a vital role in recognizing early symptoms, such as fever or cognitive changes. Lori advises patients and caregivers to stay vigilant and report even subtle signs of illness to the medical team. She reassures that the healthcare team is ready to act quickly in the event of complications, underscoring the importance of a collaborative relationship between caregivers, patients, and staff.

Lori also addresses secondary concerns, such as financial toxicity, explaining that financial coordinators work with patients to navigate insurance coverage and secure additional assistance if needed. She mentions the psychological strain patients may experience, emphasizing the normality of feeling overwhelmed and the value of a strong support network.

As the episode wraps up, Lori shares a heartwarming story of a patient who, after multiple treatments, including a transplant, faced discouraging PET scan results. With the center and Lori's support and encouragement to explore CAR T therapy, the patient proceeded with the treatment and, despite some complications, has celebrated three more Christmases with his grandchildren. This story encapsulates the hope and life-changing potential of CAR T- cell therapy.

This season is made possible thanks to our sponsors:

Kite, a Gilead company: http://www.kitepharma.com/

and Bristol Myers Squibb's CAR T support services program:https://www.celltherapy360.com/

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