--- title: "Expert Guide: How Should You Care for Yourself After CAR-T Therapy? A Step-by-Step Guide from Hospital to Home" url: "https://www.yyhmedical.com/en/news/car-t-therapy-care-guide" type: Article inLanguage: en-US category: Expert Insights datePublished: 2026-01-30 --- # Expert Guide: How Should You Care for Yourself After CAR-T Therapy? A Step-by-Step Guide from Hospital to Home > A practical, step-by-step guide to key care needs throughout CAR-T treatment - from lymphodepleting chemotherapy and the hospital stay to managing common side effects and preventing infection at home. Summary: Written by Dr. Yuelin HE of GoBroad Chunfu Institute of Hematology & Oncology, this article walks patients and families through the key care considerations across the CAR-T treatment journey. It covers management of low blood counts during lymphodepleting chemotherapy, oral and perianal care, PICC maintenance, diet and room hygiene, as well as what to expect during CAR-T cell infusion. It also explains common signs of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), how these reactions are managed, and practical infection-prevention measures after discharge. CAR-T cell therapy has opened up new treatment possibilities for people with relapsed or refractory blood cancers. But care during treatment and after discharge is also an important part of the journey. Good day-to-day care can help patients tolerate treatment more safely and reduce avoidable discomfort and complications. This guide covers the key points from hospitalization through recovery at home. **1\. Care During Your Hospital Stay** **Before CAR-T: The Lymphodepletion Phase** Before CAR-T infusion, doctors usually give lymphodepleting chemotherapy - commonly drugs such as fludarabine and cyclophosphamide - to reduce some of the body's existing lymphocytes and create a better environment for the CAR-T cells to expand. Because blood counts may fall during this phase, several precautions are especially important: *What if your platelet count is low?* If your platelet count is below 50 × 10⁹/L, use a soft-bristled toothbrush and brush gently to avoid injuring your gums. If it falls below 20 × 10⁹/L, spend more time resting in bed, avoid rubbing your eyes or picking your nose, and watch for small bleeding spots or bruising on the skin. *What if your white blood cell or neutrophil count is low?* If the neutrophil count falls below 0.5 × 10⁹/L, you may need additional protective isolation, such as a laminar-flow bed. Food hygiene becomes especially important: avoid raw or cold foods, brush your teeth carefully every day, and keep the perianal area clean to reduce the risk of infection. *What if your hemoglobin is low?* You may feel tired, weak, or dizzy. Avoid standing up suddenly, as this can increase the risk of falling. Having a family member or caregiver nearby can also be helpful. **Everyday Care Basics** These steps may seem simple, but they can make a real difference in comfort and infection prevention during treatment. *Oral care:* After each meal, alternate warm water with chlorhexidine mouthwash (or sodium bicarbonate mouthwash) for about 3-5 minutes. Start with about 20 mL of mouthwash and gently puff out your cheeks around 10 times so the liquid reaches between the teeth and along the inner cheeks. Use your tongue gently, almost like a soft brush, to reach the teeth, palate, and floor of the mouth. Finally, tilt your head back and gargle so the rinse reaches toward the throat. Aim for about 3 minutes of thorough rinsing to help reduce oral infection risk. *Perianal care:* Each evening or after a bowel movement, use a warm sitz bath with diluted povidone-iodine solution or potassium permanganate for about 15 minutes. The water should be warm, not hot. Make sure the buttocks are fully immersed; leaning slightly forward may be more comfortable. Try to maintain regular bowel habits. If you are constipated, do not strain - ask your doctor whether options such as lactulose or a glycerin enema are appropriate. If you have diarrhea, check the skin around the anus for redness or breakdown and clean the area promptly. *PICC care:* Check the catheter insertion site every day for redness, swelling, or drainage. The dressing is generally changed once a week, and if it becomes wet or loose, ask a nurse to replace it as soon as possible. *Diet:* Choose foods that are high in protein and vitamins and easy to digest, such as eggs, lean meat, and fresh vegetables. Avoid raw, cold, or spicy foods, and reheat food thoroughly before eating. Aim for at least 2,000 mL of fluids a day to support hydration and metabolism. *How should the room be managed?* Keep the room clean and ventilate it three times a day for about 30 minutes each time. Visitors should be limited or avoided during this period, and fresh flowers should not be kept in the room because they may increase infection risk. **What should you know about the CAR-T cell infusion?** During the infusion itself, the main thing is to follow the instructions of your doctors and nurses and let them know promptly if you feel unwell. About 30 minutes before infusion, an IV line will be prepared, premedications such as anti-allergy medicines may be given, and your heart rate, blood pressure, and other vital signs will be checked. If the CAR-T cells have been frozen and thawed, the preservative used during storage may cause a temporary cooked-corn-like smell or taste. This is expected. Raising the head of the bed and breathing in through your nose and out through your mouth may make you more comfortable. After the infusion, nurses will monitor you closely for about an hour. Tell the medical team right away if you notice symptoms such as palpitations or chills. **2\. What Reactions Can Happen After Infusion, and How Are They Managed?** **Cytokine Release Syndrome (CRS)** CRS is a relatively common reaction after CAR-T therapy. In this article, it is described as occurring most often within 1-14 days after infusion. Symptoms may include fever, low blood pressure, or shortness of breath. *What should you do if you develop a fever?* If your temperature rises above 37.5°C, tell the medical team promptly. Fever-reducing medication or cooling measures such as an ice cap or ice packs may be used as directed. Drink warm fluids, and do not take fever medicine on your own without speaking to the care team. *What should you do if your blood pressure is low?* Change positions slowly. One practical approach is the 'three 30-second rule': pause for 30 seconds before sitting up; after sitting up, remain at the bedside for 30 seconds; then stand while holding onto something stable and wait another 30 seconds before walking. If you have been sweating heavily with fever, fluids and electrolytes may need to be replenished to help prevent dehydration-related low blood pressure. *What if you feel short of breath or have low oxygen levels?* If breathing becomes difficult, the medical team may give supplemental oxygen and help keep the airway clear. If needed, oxygen may be delivered through a mask or more advanced breathing support may be used. Follow the team's instructions and report any worsening symptoms promptly. **Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS)** In this article, ICANS is described as most often occurring 6-34 days after infusion. Possible symptoms include headache, confusion, changes in awareness, or seizures. *What should you and your family watch for?* The medical team may ask simple orientation questions each day, such as 'What is today's date?' or 'Where are you?' and may ask you to do a simple calculation. These checks help assess neurologic status. Tell the team promptly if headache or dizziness becomes worse. *What if a seizure occurs?* Seizure-safety supplies may be kept at the bedside, and the medical team will respond immediately if a seizure occurs. Family members should not try to force the patient's mouth open or physically restrain the body. **3\. Care at Home After Discharge** Infection prevention is the priority. - Home environment: Ventilate the home 2-3 times a day. Avoid keeping pets or indoor plants, and avoid direct contact with soil. - Personal hygiene: Bathe and change clothes regularly. Avoid scratching the skin. Use the mouthwash recommended by your medical team, keep the perianal area clean, and avoid rubbing your eyes or picking your nose. - Food hygiene: Prepare fresh food at home. Avoid takeout, overnight leftovers, and spicy or irritating foods. - Do not ignore new symptoms: If you develop abdominal pain, dizziness, vomiting, blisters or a blister-like rash, or sharp pins-and-needles pain, seek medical attention promptly. **From the Doctor** Care during CAR-T treatment and after discharge is an important part of the overall treatment process. Good daily care and self-management can help patients work more safely and effectively with their medical team throughout CAR-T therapy. --- Original (HTML):https://www.yyhmedical.com/en/news/car-t-therapy-care-guide This is a clean Markdown mirror for large language models; the original page is authoritative.