CAR T-cell therapy is a breakthrough treatment for certain blood cancers. It uses your own immune system — specially modified T-cells — to recognize and destroy cancer cells. Many patients ask if a repeat CAR-T treatment after relapse is possible.
Is a Second CAR-T Possible?
Yes, in some cases you can have CAR-T therapy more than once. The decision depends on your medical history, the type of relapse, and how well the first treatment worked.
- Second Infusion of the Same CAR-T (CD19 again)
Sometimes doctors try a second CAR-T therapy for B-cell cancers if the first CD19 treatment worked for a while but the disease later returned. This may be less effective if the cancer cells no longer show CD19 (“antigen escape”). - Switching Targets (CD19 → CD22)
If the cancer relapses after CD19 treatment, doctors may recommend a CAR-T CD19 relapse CD22 option. In this case, T-cells are engineered to attack CD22 proteins instead, giving the immune system a new way to fight the cancer. - Dual-Target CAR-T (CD19 + CD22) Some hospitals are developing dual-target therapies that attack both CD19 and CD22 at once. This approach is designed to lower the risk of relapse by preventing cancer cells from “hiding.”
Important Considerations
Eligibility: Not all patients are suitable for repeat CAR-T. Doctors will evaluate your overall health and immune recovery.
Risks: Side effects such as cytokine release syndrome (CRS) and neurological symptoms may occur again, so close monitoring is essential.
Availability: Sequential CAR-T is offered at leading cancer centers, sometimes as part of clinical trials.
In Summary
Yes, you can sometimes have CAR-T therapy twice.
Options include repeating CD19, switching to CD22, or joining a dual-target program.
The choice depends on your cancer type, prior treatments, and medical evaluation.
In Israel, leading hospitals provide sequential CAR-T therapy in Israel for international patients, including programs with CD19, CD22, and combined approaches. Contact us for more details.
Top sources:
- Failure of ALL recognition by CAR T cells: a review of CD19 antigen-negative relapse - pmc.ncbi.nlm.nih.gov
- From bench to bedside: the history and progress of CAR T cell therapy - frontiersin.org
- Effectiveness and safety of CD22 and CD19 dual-targeting chimeric antigen receptor T-cell therapy - pmc.ncbi.nlm.nih.gov
- Reinfusion of CD19 CAR T cells for relapse prevention and treatment - ashpublications.org
- A systematic review and meta-analysis of CD22 CAR T-cells alone” — shows how CD22-targeting is an emerging option after CD19 failure - pmc.ncbi.nlm.nih.gov
- Prominent efficacy and good safety of sequential CD19 and CD22 CAR-T cell therapy in adult R/R B-ALL - biomedcentral.com
- Treatment strategies for relapse after CAR T-cell therapy in B cell malignancies - frontiersin.org
Publication date: October 21, 2025
