If you have a certain kind of cancer that has relapsed (come back) or didn’t respond to other treatments, your doctor might recommend Kymriah. It’s a prescription drug used to treat certain forms of the following conditions:
- B-cell precursor acute lymphoblastic leukemia in children and certain adults
- large B-cell lymphoma in adults, including diffuse large B-cell lymphoma (DLBCL), high grade B-cell lymphoma, and DLBCL that started as follicular lymphoma
- follicular lymphoma in adults*
Note: Kymriah should not be used to treat lymphoma that started in the central nervous system.
For specific details about the uses of Kymriah, see the “What is Kymriah used for?” section below.
* For this use, Kymriah received
Kymriah contains the drug tisagenlecleucel, which is a biologic medication. Kymriah belongs to a group of biologic drugs called chimeric antigen receptor (CAR) T-cell therapies.
A biologic drug is made from parts of living organisms. Specifically, Kymriah is made from your own immune cells. Kymriah is not available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.) Instead, Kymriah is only available as a brand-name drug.
Kymriah is given as an intravenous (IV) infusion (an injection into a vein over a period of time).
Read on to learn more about Kymriah.
The cost of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and the costs for receiving Kymriah infusions.
If you have questions about how to pay for your prescription, talk with your doctor or insurance provider. A program called Kymriah Cares may also be available.
Kymriah and Yescarta are a kind of treatment called chimeric antigen receptor (CAR) T-cell therapy. These medications are made from your own immune cells.
Kymriah and Yescarta are used to treat B-cell lymphoma, including diffuse large B-cell lymphoma (DLBCL), high grade B-cell lymphoma, and DLBCL that started as follicular lymphoma. Doctors can also prescribe them to treat follicular lymphoma.
Each drug treats additional conditions that the other doesn’t.
If you have questions about the similarities and differences between Kymriah and Yescarta, talk with your doctor. They can help determine which treatment option may be best for you. You can also see this article to learn how these drugs compare.
Kymriah is used to treat certain kinds of cancer that have relapsed (come back) or are refractory (didn’t respond or stopped responding to other treatments). Specifically, Kymriah can be used in:
- children and adults ages 18 to 25 years with B-cell precursor acute lymphoblastic leukemia (ALL) that’s refractory or has relapsed one or more times
- adults with certain kinds of B-cell lymphoma that are refractory or have relapsed after trying two or more systemic treatments*
- adults with follicular lymphoma who’ve tried two or more systemic treatments
See below for more details on these uses.
* Systemic treatments work throughout your body to treat your condition.
Acute lymphoblastic leukemia (ALL)
Kymriah is used to treat precursor B-cell ALL in children and adults ages 18 to 25 years. Your doctor will likely only prescribe Kymriah if you have refractory ALL or if your ALL has relapsed at least once.
ALL is a kind of cancer that occurs in white blood cells in your bone marrow. ALL most commonly occurs in children. It can develop and spread quickly. Precursor B-cell ALL means that the cancer affects a specific type of white blood cell called precursor B cells.
Kymriah is used in certain adults with specific types of large B-cell lymphoma (a kind of non-Hodgkin’s lymphoma). This kind of fast-growing cancer affects certain white blood cells called B-cell lymphocytes.
Doctors may prescribe Kymriah to treat certain kinds of large B-cell lymphoma that are refractory or that have relapsed after trying two or more systemic treatments. Kymriah is specifically used to treat:
- diffuse large B-cell lymphoma (DLBCL)
- DLBCL that started as follicular lymphoma
- high grade B-cell lymphoma
It’s important to note that Kymriah has a limitation of use. It should not be used to treat lymphoma that started in the central nervous system (CNS). Your CNS is made up of your brain and spinal cord. This type of cancer may also be called primary central nervous system lymphoma.
Follicular lymphoma (FL)
Kymriah can be used to treat FL that’s refractory or that has relapsed after trying two or more systemic treatments. FL is a slower-growing type of B-cell lymphoma.
The FDA approved Kymriah to treat FL under its
To learn more about the effectiveness of Kymriah for FL or its other uses, talk with your doctor.
Find answers below to some commonly asked questions about Kymriah.
What is Kymriah’s mechanism of action (how does it work)?
Kymriah works to treat your cancer by attaching to a certain protein on B cells. This process activates your immune system, causing it to attack cancer cells.
For more information about how Kymriah works, see the Kymriah website or talk with your doctor.
Is Kymriah used to treat multiple myeloma or chronic lymphocytic leukemia (CLL)?
Kymriah is not approved to treat multiple myeloma or chronic lymphocytic leukemia (CLL). But in some cases, the drug may be used off-label to treat these conditions. (Off-label drug use occurs when a drug is prescribed for a use that’s different than what it was approved for.)
To learn more about treatment options for multiple myeloma or CLL (including Kymriah), talk with your doctor.
Will Kymriah cure my cancer?
No, Kymriah won’t cure your cancer. There’s currently no known cure for cancer.
Kymriah works by strengthening your immune system to help your body fight cancer. In studies of the drug, some people reached complete remission. (With complete remission, there aren’t any signs of cancer in your body after treatment.)
Even if you have complete remission after taking Kymriah, it’s possible for the cancer to return. Remission doesn’t mean the cancer has been cured. Because of this, your doctor will monitor you often to be sure your cancer hasn’t come back. Your doctor can help determine the best treatment plan for you. They can also tell you more about what remission means regarding your diagnosis.
Your doctor will determine the Kymriah dosage that’s right for you.
Kymriah is given as an intravenous (IV) infusion (an injection into a vein over a period of time). The drug is made from your own immune cells.
Kymriah is given as a one-time infusion. The infusion will usually take less than 1 hour.
Your doctor will determine your specific dose of Kymriah based on many factors, including your weight and condition.
Questions about Kymriah’s dosing
Below are some common questions about Kymriah’s dosing.
- Will I need to use Kymriah long term? No, Kymriah is not a long-term treatment. This medication is given as a one-time infusion.
- How long does Kymriah take to work? As soon as you receive your dose of Kymriah, the drug will start to work in your body. But it may take time for you to notice that your symptoms are improving. Your doctor will monitor you after treatment to make sure the medication is working for you.
Like most drugs, Kymriah may cause mild or serious side effects. The lists below describe some of the more common side effects that Kymriah may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Kymriah. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects that Kymriah can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Kymriah’s prescribing information.
Mild side effects of Kymriah that have been reported include:
- decreased appetite
- nausea, vomiting, or diarrhea
- pain in your back, mouth, muscles, or belly
- fast heart rate
- shortness of breath
- fatigue (low energy)
- low blood pressure
- mild allergic reaction*
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* To learn more about this side effect, see the “Allergic reaction” section below.
Serious side effects
Serious side effects from Kymriah can occur, but they aren’t common. If you have serious side effects, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Serious side effects of Kymriah that have been reported include:
- low levels of white blood cells, which may not cause symptoms except a fever in some cases
- low levels of platelets (cells that help with blood clotting)
- abnormal heart rhythm
- kidney problems
- infections, which may be serious or life threatening
- other types of cancer, including cancer coming back or appearing in a different part of your body
- severe breathing problems, including low oxygen levels or acute respiratory failure
- nervous system problems, including encephalopathy (a condition affecting the brain) and memory problems
- weakened immune system
- low levels of immunoglobulins (proteins that help protect your body from infection), which may raise your risk of infection
- boxed warnings: risk of cytokine release syndrome and risk of neurological toxicity*
- severe allergic reaction†
* For more information, see the “What should be considered before taking Kymriah?” section below.
† To learn more about this side effect, see the “Allergic reaction” section below.
Some people may have an allergic reaction to Kymriah.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Kymriah. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Using a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before receiving Kymriah, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about interactions these items may cause with Kymriah.
For information about drug-condition interactions, see the “Other warnings” section below.
Interactions with drugs or supplements
There currently aren’t any medications or supplements known to interact with Kymriah. But you should still tell your doctor and pharmacist about any medications you take besides Kymriah.
It’s possible for Kymriah to interact with certain HIV lab tests, such as HIV RNA tests. It’s possible for Kymriah to cause a false-positive result on this test. (A false-positive happens when the test shows that HIV is present even though the person tested doesn’t have HIV.)
If you need an HIV test, tell your doctor that you’ve received Kymriah. They may recommend getting a different HIV test that doesn’t interact with Kymriah.
Examples of live vaccines include:
It’s unknown what effects the drug may have on live vaccines. But you should not get any of these vaccines in the 6 weeks before starting chemotherapy and until your immune system has recovered after your Kymriah infusion. This is because chemotherapy and Kymriah may weaken your immune system, which could cause live vaccines to make you sick.
If you need to get any vaccines, tell your doctor or pharmacist that you’ve received Kymriah. They’ll be able to help you determine if it may be safe for you to receive your vaccine.
Kymriah has two
Boxed warnings include:
Risk of cytokine release syndrome. Kymriah may cause a condition called cytokine release syndrome (CRS). This condition can occur after certain cancer treatments, such as Kymriah, and it causes your body to release proteins called cytokines into your blood. Symptoms of CRS include fever, nausea, and a fast heart rate. CRS can be life threatening in some cases.
Due to this risk, your doctor will monitor you for at least 4 weeks after your Kymriah infusion to make sure you don’t develop symptoms of CRS. If you notice any symptoms, immediately see a doctor or go to the nearest hospital.
Risk of neurological toxicity. Kymriah may cause neurological toxicity (damage to the nervous system, which includes your brain and nerves). Examples of neurological toxicity include headache, anxiety, sleep problems, dizziness, confusion, tremor, and nerve pain. More serious kinds of neurological toxicity include seizures and encephalopathy, which can be life threatening.
Due to these risks, your doctor will monitor you closely for at least 4 weeks after your Kymriah infusion to be sure that you don’t develop these side effects. If you notice any symptoms of neurological toxicity, immediately see a doctor or go to the nearest hospital.
Kymriah may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Kymriah is a suitable treatment option for you.
Talk with your doctor about your health history before you take Kymriah. The list below includes factors to consider.
- Infections. You should tell your doctor if you have any infections before receiving Kymriah. Kymriah may cause infections, and if you already have an infection, this medication may make it worse. Your doctor will recommend treating any infections before you get your dose of Kymriah.
- Hepatitis B virus. Kymriah could cause the hepatitis B virus (HBV) to reactivate (cause symptoms again) in people who have had the virus. In some cases, this may be serious and even life threatening. If you’ve had HBV before, talk with your doctor about whether Kymriah is safe for you.
There are no known contraindications for Kymriah. (A contraindication is a condition that may make it unsafe to take a specific drug.)
Kymriah and alcohol
There aren’t any known interactions between Kymriah and alcohol. But both Kymriah and alcohol can cause nausea, vomiting, or headache. So combining the two may raise your risk of these side effects or worsen them if they occur.
In addition, alcohol may weaken your immune system. This can decrease your body’s ability to fight the cancer. It may also raise your risk of infection, which is a side effect of Kymriah, too.
If you drink alcohol, talk with your doctor about how much (if any) is safe to drink with your condition and treatment plan.
Pregnancy and breastfeeding
You should not use Kymriah during pregnancy. The safety of Kymriah during pregnancy hasn’t been studied, so it’s not known if the drug may be safe or what effects it may have on a fetus. But based on how Kymriah works, it’s possible that it could cause harm to a fetus.
If you can become pregnant, your doctor will give you a pregnancy test before you receive Kymriah. They may also recommend using birth control when you’re receiving chemotherapy before your Kymriah infusion.
There haven’t been any studies done on Kymriah while breastfeeding. So it’s not known if the drug may pass into breast milk or what effects it may have on a breastfed child.
If you’re pregnant or breastfeeding, or planning to become pregnant or breastfeed, talk with your doctor before receiving Kymriah.
You’ll receive Kymriah as an intravenous (IV) infusion (an injection into a vein over a period of time) given by your doctor. The drug is made from your own immune cells.
See below for more details on how the drug is given.
Because Kymriah is made with your immune cells, you’ll first have your blood drawn in a process called leukapheresis. With this process, T cells (a type of immune cell) are collected from your blood. Leukapheresis can take 3 to 6 hours to complete. Your immune cells are then frozen and sent to a lab, where they’re altered to help fight your cancer better. This process can take 3 to 4 weeks.
Your dose of Kymriah is injected into your body through an IV infusion, which usually takes less than 1 hour.
You will only receive Kymriah at a facility certified by a Risk Evaluation Mitigation Strategies (REMS) program. This is because of the serious side effects the drug may cause. The REMS program helps ensure that your healthcare professional understands the instructions for how to properly use and store Kymriah.
For at least 4 weeks after receiving your dose of Kymriah, you should stay within a 2-hour driving distance of the infusion facility. This is so that your doctor can monitor you for side effects and make sure that Kymriah is working for you.
In addition, you shouldn’t drive a car or operate heavy machinery for at least 8 weeks after your Kymriah infusion. This is because the drug may cause side effects such as confusion, weakness, or dizziness.
These side effects may be dangerous to you or others if you experience them while driving, operating machinery, or doing other tasks that require alertness.
Using Kymriah with other drugs
Depending on the condition you’re using Kymriah to treat, your doctor may also prescribe certain chemotherapy medications 2 to 14 days before your Kymriah infusion. Your doctor will tell you whether you’ll need to take chemotherapy medications before receiving Kymriah.
In addition, 30 to 60 minutes before you receive your dose of Kymriah, your doctor will likely give you acetaminophen (Tylenol) and an antihistamine, such as diphenhydramine (Benadryl). These drugs are called premedications. They’re used to help prevent side effects from your Kymriah infusion.
If you have any questions about the medications you’ll receive before your Kymriah infusion, talk with your doctor.
Questions for your doctor
You may have questions about Kymriah and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Kymriah affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.
If you have additional questions about Kymriah, talk with your doctor. Some questions that you may want to ask include:
- What’s the success rate of Kymriah treatment?
- What should I expect in the days or weeks after my Kymriah infusion?
- Do my other medications increase my risk of side effects from Kymriah?
- What should I do if I become pregnant before my Kymriah infusion?
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.