Image used with permission from Rockland Immunochemicals, Inc. (http://www.rockland-inc.com/
A typical CAR T cell therapy involves four basic steps. (1) A patient or donor is leukapheresed to isolate peripheral blood mononuclear cells (PBMCs). (2) These cells are manipulated to express CAR by gene transfection. (3) CAR-expressing cells are differentiated into effector immune cells and expanded to sufficient number in vitro . (4) The CAR effector cells are then introduced into the patient. This is frequently done in conjunction with either chemo- or radio- therapy.