Cellular immunotherapy · London
CAR-T cell therapy – private in London.
A one-shot autologous cell therapy for relapsed or refractory blood cancers. Your own T cells, engineered to hunt CD19 or BCMA, infused at a JACIE-accredited London centre with critical-care backup and a named consultant haematologist.
Why patients choose us
- 01
Access to every UK licensed CAR-T centre
A named consultant haematologist at a JACIE-accredited CAR-T unit. King’s, UCLH, Christie, Marsden and HCA London Bridge, all in one call.
- 02
The right product for your disease
DLBCL, ALL, mantle cell, follicular, myeloma. Each licensed product has a different pathway. We match the disease to the construct and the centre.
- 03
Independent, and free
We are paid by no centre or manufacturer. The recommendation is impartial and costs you nothing.
What CAR-T is
Your own T cells, re-engineered to find cancer.
CAR-T is an autologous cell therapy. Your T cells are collected by apheresis, shipped to a manufacturing site, modified with a chimeric antigen receptor, expanded in the lab, then infused back into you.
Apheresis
A single 3–5 hour outpatient session. Blood is drawn from one arm, T cells (CD3+) are separated on a cell-processor, and the rest is returned via the other arm.
Manufacture
Cells are shipped frozen to a manufacturing site in Europe or the US. A lentiviral or retroviral vector inserts the CAR gene targeting CD19 or BCMA. Cells are expanded over 3–5 weeks.
Infusion
After 3 days of FluCy lymphodepletion, the CAR-T product is infused over 30–60 minutes. Cells expand a thousand-fold in vivo and kill CD19 or BCMA-expressing tumour cells.
UK licensed indications
Six products, six patient groups.
The MHRA-licensed and NHS-commissioned indications in the UK, plus the flags that rule CAR-T out. If your disease is outside these lines, we look at bispecific antibodies, allogeneic transplant or open trials.
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Relapsed / refractory DLBCL
Diffuse large B-cell lymphoma after two or more lines of therapy (Kymriah, Yescarta, Breyanzi). Second-line use of Yescarta and Breyanzi is now licensed in high-risk early relapse.
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Paediatric and young adult B-ALL
Kymriah is licensed for B-cell acute lymphoblastic leukaemia in patients up to 25 years who are refractory, in relapse post-transplant, or in second or later relapse.
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Relapsed mantle cell lymphoma
Tecartus is licensed for adults with r/r mantle cell lymphoma after two or more prior lines including a BTK inhibitor.
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Relapsed follicular lymphoma
Yescarta and Kymriah are both options in adults with r/r follicular lymphoma after three or more lines of systemic therapy.
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Heavily pre-treated multiple myeloma
Abecma and Carvykti (both BCMA-directed) are licensed after four prior lines including an IMiD, a PI and an anti-CD38 antibody.
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High-grade B-cell lymphoma, DHL / THL
Double-hit and triple-hit lymphomas with MYC and BCL2 or BCL6 rearrangements are included in the DLBCL licence for CD19-directed products.
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Primary mediastinal B-cell lymphoma
PMBCL after two or more prior lines is included in the third-line DLBCL licence for Yescarta and Kymriah.
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Not eligible: active CNS disease, severe organ failure
Active uncontrolled CNS lymphoma, EF under 40%, DLCO under 40%, GFR under 30 or ECOG 3–4 usually rule out standard CAR-T pathways.
The process
From screening to discharge – what happens, in order.
Ten to twelve weeks end to end, most of it either off-stage (during manufacture) or under close inpatient observation for CRS and ICANS.
- 01
Before
Send us the histology and staging
Diagnosis, prior lines of therapy, most recent PET-CT and bone-marrow report. A short, confidential form. We reply within one working day.
- 02
Before
MDT eligibility review
The CAR-T MDT confirms whether you meet the licensed indication, whether the NHS Cancer Drugs Fund pathway applies, and whether self-pay is a route.
- 03
Before
Screening and consent
Cardiac, pulmonary and renal work-up, viral serology, ECOG performance status. Consent covers CRS, ICANS, cytopenias and infection risk.
- 04
On the day
Apheresis, then manufacture
T cells are collected over a 3–5 hour apheresis session. Cells ship to a US or European manufacturing site. Turnaround: 3–5 weeks.
- 05
On the day
Bridging therapy and lymphodepletion
Chemotherapy or radiotherapy bridges disease control during manufacture. FluCy lymphodepletion (fludarabine + cyclophosphamide) for 3 days before infusion.
- 06
On the day
CAR-T infusion
A single 30–60 minute intravenous infusion of your modified T cells. Admission the day before, monitored bed for the infusion itself.
- 07
After
Inpatient monitoring, 4–8 weeks
Daily neuro assessments, temperature checks and blood counts. Tocilizumab and steroids on standby for CRS or ICANS. Discharge planning at day 14–28.
Side effects and safety
What to expect – honestly.
CAR-T works by triggering a very large immune response. CRS and ICANS are expected, and every CAR-T unit is set up to manage them. Long-term issues are cytopenia, infection and low immunoglobulins.
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Cytokine release syndrome (CRS)
A systemic inflammatory response in 70–95% of patients: fever, hypotension, hypoxia. Graded 1–4 (ASTCT). Treated stepwise with tocilizumab and steroids. Grade 3–4 CRS is uncommon in modern practice.
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ICANS neurotoxicity
Immune effector cell-associated neurotoxicity: tremor, aphasia, confusion, rarely seizures or cerebral oedema. Peaks days 5–10. Managed with steroids and supportive care.
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Prolonged cytopenias
Neutropenia, anaemia and thrombocytopenia can last weeks to months. Regular blood support and G-CSF are standard. A small subset need eltrombopag or a stem-cell boost.
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Infection risk
PJP, HSV and CMV prophylaxis for months. Live vaccines are avoided. Any fever after discharge is treated as neutropenic sepsis until proven otherwise.
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Hypogammaglobulinaemia
B-cell aplasia is expected with CD19 CAR-T. IVIG replacement is often needed if IgG falls below 4 g/L or if recurrent infections develop.
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Secondary malignancies (rare)
The FDA and MHRA now flag rare T-cell malignancies after CAR-T. Absolute risk is very small and does not outweigh the survival benefit in eligible patients.
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30-day driving restriction
You must not drive or operate machinery for at least 8 weeks after infusion, per the SmPC, because of the ICANS risk window.
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Fertility considerations
FluCy is gonadotoxic. Sperm banking and oocyte / embryo preservation are offered before conditioning where clinically appropriate.
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Long-term follow-up, 15 years
Regulators require 15 years of follow-up for gene-modified cell therapies. Annual review continues via your CAR-T centre.
Indicative pricing
What private CAR-T costs in the UK.
NHS-commissioned CAR-T is free at the point of use through the Cancer Drugs Fund for licensed indications. Self-pay ranges here are all-inclusive per infusion (product, apheresis, admission, ICU stand-by) for international and self-funding patients.
In short
A private, all-inclusive CAR-T pathway in London: £320,000–£420,000 per infusion, 4–8 weeks in-country.
| Product / pathway | Indicative range | Typical admission | Manufacture |
|---|---|---|---|
| MDT eligibility review and second opinion | £600–£1,200 | 60 min consult | 5–10 working days |
| Kymriah (tisagenlecleucel) - DLBCL / ALL | £320,000–£380,000 | 4–8 weeks inpatient | 3–5 weeks manufacture |
| Yescarta (axicabtagene ciloleucel) - DLBCL / FL | £340,000–£400,000 | 4–8 weeks inpatient | 3–4 weeks manufacture |
| Tecartus (brexucabtagene autoleucel) - mantle cell | £350,000–£410,000 | 4–8 weeks inpatient | 3–4 weeks manufacture |
| Breyanzi (lisocabtagene maraleucel) - DLBCL | £340,000–£400,000 | 4–8 weeks inpatient | 3–4 weeks manufacture |
| Abecma (idecabtagene vicleucel) - myeloma | £360,000–£420,000 | 4–8 weeks inpatient | 4–6 weeks manufacture |
| Carvykti (ciltacabtagene autoleucel) - myeloma | £380,000–£420,000 | 4–8 weeks inpatient | 4–6 weeks manufacture |
Cost varies by product, by centre and by length of admission. If the NHS Cancer Drugs Fund pathway applies to your case, we say so honestly and refer you into it – there is no private route that will be quicker or better.
UK CAR-T centres
Five NHS-accredited CAR-T units, one introduction.
Every UK CAR-T centre is JACIE-accredited and commissioned by NHS England. The private wings of these hospitals use the same consultants and the same clinical infrastructure.
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King’s College Hospital Private
Denmark Hill, London. Adult DLBCL, mantle cell, follicular and myeloma pathways with on-site HDU / ICU.
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University College London Hospital Private
Euston, London. UCLH is a leading UK CAR-T centre for lymphoma and myeloma, with a large early-phase trials portfolio.
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The Christie Private Care
Manchester. NHS regional CAR-T hub for the North of England. Adult and TYA lymphoma and myeloma programmes.
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The Royal Marsden Private
Chelsea and Sutton. Adult and paediatric CAR-T, strong TYA (teenage and young adult) B-ALL pathway.
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HCA London Bridge Hospital
London Bridge. Private CAR-T with UCLH and King’s consultant links, popular with international patients.
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Great Ormond Street Hospital
Bloomsbury, London. Paediatric Kymriah for B-ALL. The UK’s largest paediatric CAR-T experience.
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JACIE-accredited CAR-T centres commissioned by NHS England
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Named consultant haematologist with CAR-T MDT experience
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Level 2 / 3 critical care on the same site for CRS and ICANS escalation
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International patient pathways with concierge, visa and accommodation support
Outcomes
What the trial and real-world data actually show.
Response rates from the ZUMA, JULIET, TRANSCEND, ELIANA, KarMMa and CARTITUDE registration trials, with UK real-world data broadly consistent.
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DLBCL, third line
Complete response at 12 months in 40–50% of patients across Yescarta, Kymriah and Breyanzi trials. Around 30–40% are in ongoing remission at 5 years.
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B-ALL paediatric
Kymriah (ELIANA): complete response at 3 months in 60–80% of children and young adults with r/r B-ALL. Event-free survival of 40–50% at 2 years.
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Multiple myeloma
Abecma (KarMMa): 70% overall response, 30% complete response. Carvykti (CARTITUDE-1): 95% overall response, 70–80% complete response.
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Mantle cell / FL
Tecartus in mantle cell (ZUMA-2): 90% overall response, 65% complete response. Yescarta in follicular (ZUMA-5): 90% overall response, 75% complete response.
Product options and alternatives
CAR-T is a family – and alternatives sit beside it.
The licensed CAR-T constructs and the neighbouring options we weigh up with your MDT.
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CD19 CAR-T (Kymriah, Yescarta, Tecartus, Breyanzi)
A chimeric antigen receptor targeting CD19 on B cells. The workhorse construct for lymphomas and B-ALL. Costimulatory domain differs (4-1BB vs CD28) which affects CRS and persistence.
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BCMA CAR-T (Abecma, Carvykti)
Targets B-cell maturation antigen expressed on plasma cells. Used in relapsed / refractory multiple myeloma. Carvykti has two BCMA-binding domains and deeper responses in trials.
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Bridging chemotherapy
A short course of chemotherapy or radiotherapy between apheresis and infusion, to hold disease stable during the 3–5 week manufacturing window.
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Lymphodepleting conditioning (FluCy)
Fludarabine 30 mg/m² and cyclophosphamide 500 mg/m² daily for 3 days before infusion. Creates space for the CAR-T cells to expand.
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Tocilizumab and steroid rescue
IL-6 receptor blockade with tocilizumab is first-line for CRS. Corticosteroids are added for higher-grade CRS or for ICANS. Both are kept at the bedside.
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Bispecific antibody therapy (alternative)
Off-the-shelf T-cell engagers such as glofitamab, epcoritamab, teclistamab and elranatamab. No manufacturing wait, but continuous dosing and different toxicity profile.
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Allogeneic stem-cell transplant (alternative)
A donor transplant remains an option for some fit patients, particularly younger ALL patients or those with matched sibling donors, but morbidity is higher.
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Clinical trial CAR-T constructs
CD22, dual CD19/CD22, GPRC5D and allogeneic “off-the-shelf” CAR-T products are in UK trials. We can flag suitable open studies where the licensed product is not the best fit.
Reading your CAR-T record
Your CAR-T record in four parts.
Whichever product you receive, your record from the CAR-T centre keeps to the same shape.
A quiet reminder
CAR-T language is precise and can read coldly – we translate it for you.
If you would like us to talk you through the record before your next review, just ask.
- 01 Screening
Eligibility, staging and organ function
Diagnosis with molecular subtype, lines of prior therapy, PET-CT staging, bone-marrow, cardiac EF, DLCO, GFR and ECOG performance status.
- 02 Manufacture
Apheresis yield and product release
CD3+ yield at apheresis, transduction efficiency, viability and cell dose. Certificate of analysis before infusion.
- 03 Toxicity
CRS and ICANS grading
ASTCT consensus grades day by day, tocilizumab and steroid doses, and any ICU input. Baseline for future care.
- 04 Response
Day 30 / 90 / 180 restaging
PET-CT or bone-marrow at day 30, 90 and 180. Complete response, partial response, stable or progressive disease per Lugano or IMWG criteria.
Recognised by major UK insurers
Standard UK insurance rarely covers CAR-T because it is NHS-commissioned. International and global policies may pre-authorise on a case-by-case basis.
Frequently asked
Everything we get asked about CAR-T.
Quick answers on eligibility, outpatient pathways, NHS vs private, re-treatment, insurance and travelling from abroad.
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Am I too old (or too young) for CAR-T?
There is no strict upper age limit for the lymphoma and myeloma products, and fit patients in their 70s and even early 80s are routinely treated. What matters is performance status, cardiac and lung function, and disease control. Kymriah for B-ALL is licensed up to age 25; the DLBCL, mantle cell, follicular and myeloma products are for adults 18 and over.
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Can CAR-T be done as an outpatient?
Selected patients now receive Breyanzi and some Yescarta infusions in outpatient CAR-T programmes with 24/7 rapid readmission. The default in the UK remains a 10–14 day inpatient admission followed by close outpatient monitoring for 4–8 weeks, because CRS and ICANS peak in the first 2 weeks.
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NHS vs private: what is the difference?
For every licensed indication above, the NHS Cancer Drugs Fund funds CAR-T at a JACIE-accredited NHS centre. Private self-pay is only meaningful if the NHS pathway does not apply to your specific case (for example licensing gaps, international patients, or trial-only constructs). We are honest about which route fits.
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Can I have CAR-T a second time?
Re-treatment with the same product is possible in a minority of patients who relapse after an initial response and still have CD19 or BCMA expression, but data are limited. Switching to a different CAR-T, a bispecific antibody or an allogeneic transplant is more common at second relapse.
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Will private health insurance cover CAR-T?
Most UK insurers exclude CAR-T from standard cover because it is funded on the NHS for licensed indications. Some international and high-value policies (Cigna Global, Bupa Global, AXA Global, WPA International) will consider CAR-T on a case-by-case pre-authorisation.
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Can I travel from abroad for CAR-T?
Yes. King’s, UCLH, Christie, Marsden and HCA London Bridge all run international patient pathways. Plan on 10–12 weeks in the UK: 2 weeks work-up, 4–6 weeks around apheresis and manufacture, 4–8 weeks post-infusion monitoring. We coordinate concierge, visa and accommodation.
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Breast cancer
Private diagnosis and treatment pathways for breast cancer.
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Ready to enquire?
Send us the histology and the last PET-CT. We come back within one working day.
A short, confidential form. We tell you whether CAR-T is licensed for your disease, whether the NHS Cancer Drugs Fund route applies, and which UK centre we would recommend for your case.