CAR-T Infection Prevention

When undergoing CAR-T infection prevention must be at the top of your mind. I say this because, according to research, infection is almost 50% of non-relapse deaths of CAR-T therapy patients.

I also say this because I’m a long-term MM survivor who relies on non-conventional therapies to manage my long-term and late stage side effects.

What are non-conventional therapies for cancer patients to reduce the risk of infection?

1. Probiotics and Prebiotics

Probiotics are beneficial bacteria that can help maintain a healthy gut microbiome, which is crucial for immune function. Some studies suggest that probiotics may help prevent infections in cancer patients, particularly those undergoing chemotherapy.
Prebiotics are non-digestible fibers that feed beneficial gut bacteria. A balanced gut microbiome can enhance the body’s natural defenses against infections.

2. Nutritional Therapy

Immune-Boosting Foods: Consuming a diet rich in vitamins and minerals, especially vitamin C, vitamin D, zinc, and selenium, can support the immune system. Foods like citrus fruits, leafy greens, nuts, seeds, and lean proteins are beneficial.
Herbal Supplements: Some herbs, such as echinacea, astragalus, and elderberry, are believed to support immune function. However, these should be used with caution and under the guidance of a healthcare provider, as they may interact with conventional cancer treatments.

3. Mind-Body Practices

Stress Reduction: Chronic stress can weaken the immune system. Practices like yoga, meditation, and deep-breathing exercises can help manage stress and potentially enhance immune function.
Acupuncture: Some studies suggest that acupuncture may help modulate immune responses and reduce the frequency of infections in cancer patients by improving overall well-being and reducing stress.

4. Physical Activity

Moderate Exercise: Regular, moderate physical activity can boost the immune system. Activities like walking, swimming, or gentle yoga can help improve circulation and overall immune function.

5. Essential Oils

Aromatherapy: Essential oils like tea tree, eucalyptus, and lavender have antimicrobial properties. While not a replacement for conventional treatments, they can be used in aromatherapy to promote relaxation and potentially support the immune system.

6. Hydrotherapy

Contrast Showers: Alternating between hot and cold water during showers can stimulate circulation and may help improve immune function. This practice is often used in naturopathic medicine as a supportive therapy for the immune system.

7. Homeopathy

Some cancer patients use homeopathic remedies to boost immunity and reduce infection risk. However, the effectiveness of homeopathy is highly debated, and it should only be used under the guidance of a professional familiar with its use in cancer care.

8. Vitamin and Mineral Supplements

Vitamin D: Adequate levels of vitamin D are crucial for immune function. Supplements may be recommended, especially in patients with low levels.
Glutamine: This amino acid may help maintain gut integrity and reduce the risk of infections, particularly in patients receiving chemotherapy.

9. Mushroom Extracts

Certain medicinal mushrooms like reishi, shiitake, and turkey tail have immune-boosting properties and are sometimes used as supplements in cancer care.

10. Traditional Chinese Medicine (TCM)

TCM practices, including herbal medicine, acupuncture, and qigong, may support immune function and overall health. TCM approaches are often personalized based on the individual’s specific needs and symptoms.

Important Considerations

Safety and Interactions: Some non-conventional therapies can interact with cancer treatments, leading to adverse effects. Always consult with an oncologist or a healthcare provider before starting any new therapy.
Personalization: What works for one patient may not work for another. Non-conventional therapies should be tailored to the individual’s condition, type of cancer, and treatment plan.

Remember that the therapies listed are complementary and should support the conventional therapies for CAR-T infection prevention that are prescribed by your oncologist.

Remember also that these therapies may be utilized during the time before the patient undergoes CAR-T therapy due to possible interference with conventional therapies.

If you would like to learn more about evidence-based non-conventional therapies email me at David.PeopleBeatingCancer@gmail.com

Thank you,

David Emerson

MM Survivor
MM Cancer Coach
Director PeopleBeatingCancer

Managing Infection Complications in the Setting of Chimeric Antigen Receptor T cell (CAR-T) Therapy

“Chimeric antigen receptor T-cell (CAR T-cell) therapy has changed the paradigm of management of non-Hodgkin’s lymphoma (NHL) and Multiple Myeloma. Infection complications have emerged as a concern that can arise in the setting of therapy and lead to morbidity and mortality.

In this review, we classified infection complications into three categories,

pre-infusion phase from the time pre- lymphodepletion (LD) up to day zero,
early phase from day of infusion to day 30 post-infusion,
and late phase after day 30 onwards.

Infections arising in the pre-infusion phase are closely related to previous chemotherapy and bridging therapy. Infections arising in the early phase are more likely related to LD chemo and the expected brief period of grade 3-4 neutropenia. Infections arising in the late phase are particularly worrisome because they are associated with adverse risk features including prolonged neutropenia, dysregulation of humoral and adaptive immunity with lymphopenia, hypogammaglobinemia, and B cell aplasia.

Bacterial, respiratory and other viral infections, protozoal and fungal infections can occur during this time . We recommend enhanced supportive care including prompt recognition and treatment of neutropenia with:

growth factor support,
surveillance testing for specific viruses in the appropriate instance,
management of hypogammaglobulinemia with repletion as appropriate and extended antimicrobial prophylaxis in those at higher risk (e.g. high dose steroid use and prolonged cytopenia).

Finally, we recommend re-immunizing patients post CAR-T based on CDC and transplant guidelines…

Conclusions-

In conclusion, the key findings underscore the critical role of prophylactic and preventative strategies, early recognition, and treatment of infection since this is the primary driver of NRM in CAR-T recipients.

Prophylactic and preventative strategies for all patients are imperative to mitigate the risk of serious infections. Furthermore, the importance of supportive strategies for immune reconstitution and effective cytopenia management is emerging as a pivotal aspect of patient care, potentially contributing to a reduction in infection-related complications.

The time-sensitive nature of prompt evaluation and management, particularly in the early post-infusion period for neutropenic patients, is a crucial element in enhancing patient outcomes. The broader implications for the future of CAR-T therapy and patient well-being extend beyond the initial four weeks, highlighting the need for ongoing vigilance and a sustained focus on infection prevention, even after patients have returned to the community.

Improved communication with the ATC beyond the early phase will be important to guide infection monitoring and treatment. This comprehensive understanding of infection dynamics in CAR-T recipients serves as a foundation for refining therapeutic approaches and optimizing patient care to enhance the overall success of CAR-T therapy.”

Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission