CAR T-Cell therapy is a relatively new and evolving field of medicine that has provided nurses with a critical, frontline role in managing patients through every phase of the process.

This is a whole new ball game,” Ty Simpson told the NSWNMA Professional Day audience when outlining the journey he and other haematology nurses had navigated in the development of CAR T-Cell therapy.

Ty was named Nurse of the Year at the HESTA Australian Nursing and Midwifery Awards in 2025 for his pioneering work delivering this ground-breaking form of cancer immunotherapy to patients. He is the first CAR-T Clinical Nurse Consultant at The Alfred Hospital in Melbourne.

CART-Cell therapy is a new treatment that requires a lot of workforce education, he says.

“If you talk about T-Cells, there are nursing considerations that we’ve never had to think about before. We have a whole new model of care,” he said.

“We have new escalation processes, and we have new medications that we need to be giving. Patients that go to intensive care often have neurotoxicity, and there’s certain types of nursing care that we deliver at the bedside.

“It plays with people’s immune systems. They get low blood counts. They’re at risk of infections. How we educate our patients and talk with them is going to change.”

Ty says he has a passion for advancing nursing practice and nurse-led innovation.

It was imperative, he says, to “work closely with the ward to uplift, upskill, and develop our nurses” so they are equipped to meet the challenges of the new treatment.

“We started doing multidisciplinary education days where we would hear from our neurologists, neuropsychologists, pharmacy, cell therapy unit, apheresis nurses, inpatient nurses, outpatient nurses, cancer day unit and clinical trials.

“We would all come together and say, ‘These patients are coming. What are we going to do?’”

Partnering with referral centres

Ty says creative innovations such as ‘CAR T Nurse Champions’, and ‘CAR T study days’ built valuable connections with nurses from clinical trials or from inpatient units.

There was a sharing of information with referral centres and a sharpening of communication, he says.

“We invited nurses that were receiving these patients after this complex care to come and work with us, (to be) with their patients through the whole continuum, so that when they went home, they were comfortable managing these complications that sometimes are life-threatening.

“We knew that we had to upskill our emergency departments and intensive care units, which we did. Very quickly we had buy-in from all the departments.”

Initially there were only four nurses to upskill and support nurses in the field, he says.

“Last year, there was 120 of us at our annual conference. (At this year’s annual congress) we had 160 nurses from around Australia, New Zealand, Malaysia, Singapore, and Hong Kong.

“We as a group never intended for anything to be bigger than what we wanted it to be. And that was a community of work that made sure that patients, regardless of their postcode, got the same care, whether they were in Melbourne or in Alice Springs, and we’ve done that. So, I’m very, very happy.”

What is CAR T-Cell therapy?

Car T-Cell therapy is a type of immunology that re-engineers a patient’s own blood cells to hunt and destroy cancer cells. It works through:

Cell collection: Blood is drawn from the patient and T-Cells are separated out through a process called leukapheresis

Laboratory modification: Scientists add a gene for a special receptor – called a chimeric antigen receptor (CAR) to the T-Cells in a specialised laboratory

Multiplication: The modified CAR T-Cells are grown and multiplied into massive numbers

Infusion: The cells are modified back into the patient’s bloodstream where they recognise and kill cancer cells carrying the targeted antigen.

Ty Simpson says that CAR T-Cells are an important regulator in immune function.

“T-Cells themselves are very, very powerful. These are all native cells that we have in our bodies,” he explains.

“We collect them via a process called apheresis. We take the cells away, and we send them off to a manufacturing facility.

“For patients with lymphoma, there’s a specific antigen we use. For patients with myeloma, there’s a specific antigen we use.

“During that time, we give the patient treatment – which takes about four to eight weeks. They come back to the hospital, and we infuse them.”

Ty says that CAR T-Cell therapy is now “in replacement of palliation”.

“These patients that otherwise would have been palliated, now are cured. About 30 per cent of patients with lymphoma are cured. And about 30 per cent of patients with multiple myeloma, which has previously been described as an incurable blood cancer, we haven’t said cured, but 30 per cent of them are in remission at five years.”