What is the difference between ASCT and CAR-T therapy?

Both CAR-T cell therapy and autologous stem cell transplant use your own cells as part of treatment, but they work in very different ways. So what's the difference? In this HealthTree University video we’ll break down how each treatment works, what they have in common, and how they differ. What's the difference between CAR-T therapy and an autologous stem cell transplant? If you're watching this video, it means your doctor might have told you that you would benefit from Car-T therapy. What I wanted to discuss in this video is what's the difference between Car-T therapy or chimeric antigen receptor therapy versus autologous stem cell transplant? Both are used to treat blood cancers. Both can benefit patients, but both are completely different from one another. So let's break that down. Let's start with CAR-T-cell or chimeric antigen receptor T cell therapy. This is a therapy that we use. It's a novel therapy that we use to fight off blood cancer. In this therapy we are going to need to collect T cells. So we are going to need to use something called an apheresis machine, where a patient gets hooked up to this machine. And similar to dialysis, this machine is going to be programed to take out the T cells. What are T cells? T cells are part of our immune system. They're called lymphocytes. They're used to fight off infection. But they can also fight off cancer. These T cells are then going to be sent to the lab, where they're going to be genetically modified to become these perfect soldiers that are going to recognize the cancer cells as foreign, attack. And that is the strategy for how we collect T cells and use them against our cancer cells. On the other side, there's something called autologous stem cell transplant. In this type of therapy, it's also a therapy to treat blood cancers, but the mechanism of action is completely different. In autologous stem cell transplantation, we use a very large dose of chemotherapy that's very effective against the cancer. And the use or the purpose of this big dose of chemotherapy is to wipe out residual disease. The problem is, is if we just give this big dose of chemotherapy, our bone marrow would be wiped out completely and would never recover. So in order to counteract that, we're going to have to collect stem cells. So what are stem cells? Stem cells are these very immature cells that are usually found in our bone marrow. And they can mature to become any one of our blood cells, our white blood cells, our red blood cells, our platelets. So what we essentially are doing is we're collecting these stem cells to rescue our bone marrow after a big dose of chemotherapy. For both procedures, we need to collect these stem cells. We need to collect these T cells. The collection process is very similar for the T cell collection. We don't need any other therapy prior to increase those T cells. We just get a special line, a central line that goes into the chest and the patient gets connected to the machine and those T cells are taken out. However, with stem cells it's a little bit different. Patients are given injections that they take every day, usually about five injections before they get collected. This injection is going to stimulate the bone marrow to make more stem cells and release those stem cells into the peripheral blood, so that when the patient is hooked up to this apheresis machine for collection, there's going to be plenty of stem cells to collect. Here's another difference between the two. T cells, once collected, are going to be sent to the lab, where they're going to be genetically modified to become these perfect soldiers to fight off cancer. On the other hand, stem cells are not going to be modified. They're actually going to be frozen, and they can be frozen for a very long time. They can be frozen for many, many years. So in case you need another stem cell transplant in the future, they're there for you. Often we collect for two transplants, and we can freeze them for ten years or beyond if we need to. Although these two therapies both need collections, right? One is T cell collection. One is stem cell collection. They're both very different therapies with very different strategies, but both very effective at fighting off blood cancer. While both CAR-T therapy and stem cell transplant use your own cells, they fight cancer in very different ways. Understanding these differences can help you and your doctor decide which treatment might be right at a certain point in your journey. To keep learning, check out the other videos in our CAR-T treatment course.