Kolkata: NRS Medical College has taken the lead in introducing CAR T-Cell (Chimeric Antigen Receptor T-cell) therapy, an advanced form of cancer treatment, among govt hospitals in eastern India. This therapy is meant for specific blood cancers that have either relapsed or are not responding to standard chemotherapy. In fact the haematology unit at the state-run hospital is also the pioneer in bone marrow transplant in eastern India in 2009.A highly personalized form of immunotherapy, the procedure involves extracting the patient’s own T-cells (white blood cell), genetically engineering them in the lab to attach specific receptors called CARs, and infusing them back into the patient’s body to hunt and destroy cancer cells.
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This treatment is used for specific blood cancers, including leukaemia, lymphoma, and multiple myeloma.According to doctors, a 37-year-old Kolkata Police sergeant was diagnosed with B-cell Acute Lymphoblastic Leukaemia (B-ALL), in March 2024. The patient responded well initially to chemotherapy but symptoms started recurring later. On evaluation, he was found to have a very early relapse.“In leukaemia management, timing and adequate response to therapy dictate prognosis, and very early relapse carries the highest resistance and poorest prognosis,” said a haematologist involved in the patient’s treatment.The early relapse made doctors plan for immunotherapy followed by stem cell transplantation with stem cell donated by his brother. But despite advanced immunotherapy drugs along with other high end drugs assessment found non-remission.Doctors said given the nature of resistant and the aggressive disease, with little to no response to even novel agents, the option of undergoing a bone marrow transplant became non-feasible, as it requires the disease to be in complete remission. The treating team decided to give him an alternate regimen with high-dose therapy and reduce the disease burden so that the patient could qualify for the criteria for CAR-T-based therapy.The work up for the therapy began in Jan this year with drugs for remission. Subsequently, the patient was put under the CAR T-cell therapy in April this year. In US, CAR T is one of the most expensive treatments in modern medicine. But the NRS team used an indigenous CAR T product, manufactured by the collaboration of IIT-Bombay and TMH, Mumbai.Despite successful procedure the patient developed cytokine release syndrome and sepsis pushing him into refractory shock. He died five days later.“This was the first CAR T-cell therapy for any govt hospital in eastern India. Despite all efforts we could not save the patient who died later due to complications. But this is no deterrent for us to carry on with this advanced treatment for cancer which can benefit patient who cannot afford this expensive treatment in private facilities,” said NRS Medical College Hospital haematology department head Tuphan Kanti Dolai.Doctors said the therapy including the pre-treatment workups, the CAR T product, clinical manufacturing logistics, one–two weeks of hospitalization, and supportive ICU care for toxicity management—the overall clinical expense typically totals between Rs 40 to Rs 75 lakh for a patient.
