Does CAR T-Cell Therapy Cause Hair Loss?

Chimeric antigen receptor (CAR) T-cell therapy can cause a wide range of side effects. You may be wondering how this treatment will affect you. Because many cancer treatments can cause hair loss, you may wonder if you will lose your hair during CAR-T. CAR-T itself does not cause hair loss. But some treatments that are given before CAR-T can cause hair loss. 

What is CAR T-cell therapy?

CAR-T is a personalized immunotherapy used to treat certain blood cancers. During treatment, a patient’s own T cells are collected and genetically modified in a laboratory to recognize and attack cancer cells. T cells are a type of white blood cell. They are a part of the immune system.

After the modified cells are multiplied and infused back into the body, they can identify and destroy cancer cells more effectively. Unlike many chemotherapy drugs, CAR-T is designed to target cancer cells directly. It does not target rapidly dividing healthy cells such as those in hair follicles.

Some people may notice hair thinning or hair loss before or after treatment for reasons that are not directly related to CAR-T itself. This is most often caused by the chemotherapy given before CAR-T starts. Understanding what causes these changes can help you know what to expect and when to talk with your care team.

What is conditioning therapy before CAR-T?

Before CAR T-cell therapy is given, some people may need conditioning chemotherapy, also called lymphodepleting chemotherapy. This is when chemotherapy is given before CAR-T. It destroys existing T cells in your body. This gives more space for the engineered T cells to work. 

Though this is a short round of chemotherapy, it can cause some hair thinning or temporary hair loss. Chemotherapy destroys fast-growing cancer cells. But it can also affect other rapidly growing healthy cells, including those in hair follicles. Not all chemotherapy drugs cause hair loss, and the amount of hair loss varies depending on the type and dose of treatment. 

If you are concerned about hair thinning during conditioning chemotherapy, ask your healthcare team if the type of chemotherapy you will receive can cause hair loss.

What are common side effects of CAR-T? 

CAR-T can cause low blood cell counts, infections, fatigue, and flu-like symptoms such as fever and chills. Some people also develop low antibody levels, which can make it harder to fight infections.

There are two major side effects of CAR-T that you should watch for: cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). 

Cytokine release syndrome (CRS) is an immune response that occurs when an excess of cytokines (proteins) are released into the bloodstream. This leads to inflammation that can damage organs and tissues. CRS is classified by grades that range from one (more mild) to four (more severe).

Immune effector cell-associated neurotoxicity syndrome (ICANS) is a neurological response that occurs when immune cells fight healthy nerves and cause inflammation. ICANS can cause brain damage and, in some severe cases, can lead to death. 

Your healthcare team will monitor you closely and treat any side effects if they occur.

Coping with cancer-related hair loss

While hair loss is not considered a common side effect of CAR T-cell therapy, every treatment journey is different. If you notice changes in your hair before, during, or after treatment, talk with your healthcare team. They can help determine whether the cause is related to previous treatments, medications, nutrition, stress, or another factor and recommend ways to support your overall health and recovery.

Hair changes can affect how you feel about your appearance, even if they are temporary. Some people choose wigs, scarves, hats, or gentle hair care products while their hair recovers. Others find it helpful to connect with people who have gone through similar experiences and can share practical tips and reassurance.

Connect with others and learn more

Learning from others who have been through CAR-T can also help you know what to expect. Through HealthTree Connect, you can chat with patients who have firsthand experience, ask questions, and share your own journey with a supportive community.

HealthTree Connect

Source: 

• Mayo Clinic-Chemotherapy and Hair Loss