NHS Delivers First CAR-T Treatment for Adult B-cell ALL Patient

The first patient to receive a pioneering form of CAR-T therapy for aggressive leukaemia on the NHS has described the experience as both “fantastic” and “very sci-fi”.

Oscar Murphy, 28, from Bury, became the inaugural recipient of the treatment for B-cell acute lymphoblastic leukaemia (B-cell ALL) at Manchester Royal Infirmary on 2 January, when he began the first of two infusions of his genetically modified immune cells. The immunotherapy, often referred to as a “living drug”, is designed to recognise and kill cancerous cells and will now be funded across several NHS centres in England. Around 50 patients a year are expected to qualify, though clinicians believe the number could rise.

Murphy was diagnosed with B-cell ALL in March 2025 and initially underwent chemotherapy followed by a donor stem cell transplant in July. His cancer relapsed just months later. “The leukaemia I've got is so fast-acting,” he said. “It needs an even quicker response to stop it. And we've now got an answer for that.”

Clinical trial data underpinning the NHS rollout showed 77% of patients entered remission after treatment, with half displaying no detectable cancer three and a half years later. On average, patients gained an additional 15.6 months of life.

According to Murphy’s haematologist, Dr Eleni Tholouli, the new iteration of CAR-T therapy is both safer and more effective than existing options. “Usually, this type of leukaemia is very aggressive and adult patients don't live beyond six to eight months. With this therapy, we are able to offer them years and potentially a cure. It's very significant and is revolutionising the way we tackle this cancer.”

CAR-T therapy has been available on the NHS for several years for certain leukaemias and lymphomas, but this marks the first time adults with B-cell ALL have had access to the treatment.

The breakthrough also comes amid ongoing conversations about who can access CAR-T therapies and when. In our earlier feature on Myeloma UK’s campaigning efforts, stakeholders warned that while the science is advancing quickly, equitable access across the NHS is yet to catch up.

Murphy’s personalised therapy required T-cells to be extracted and sent to a manufacturing site in Stevenage, where they were engineered using a viral vector to introduce a genetic sequence that enables them to recognise malignant cells. Newly expressed surface receptors act like a lock-and-key system to identify the cancer, transforming the cells into chimeric antigen receptor T-cells, or CAR-T cells, which are expanded into the millions before being cryopreserved.

The first infusion delivered around 100 million CAR-T cells contained in just a few teaspoons of fluid. A second infusion of 300 million cells followed. As a living therapy, the reprogrammed T-cells are expected to persist in the body, continue dividing and maintain anti-cancer activity over time. Murphy admitted he was astonished that such a small volume could deliver such a potent intervention. “It's very sci-fi, but if it means it gets rid of the cancer permanently and my own cells can do it it's just fantastic.”

The treatment is manufactured by Autolus, a University College London spin-out. During earlier clinical studies, patient cells had to be shipped to laboratories in the US, underscoring the significance of onshore manufacturing capacity. The therapy carries a list price of £372,000 per infusion, though the NHS has negotiated confidential discounts.

Eligible patients over 26 whose B-cell ALL has relapsed or failed to respond to treatment will be able to access the therapy at centres in Manchester, Cambridge, Newcastle, Sheffield, Plymouth and London. Patients from Wales and Northern Ireland will need to travel to England, and the treatment is not yet approved in Scotland. NHS England estimates that around 50 patients a year may benefit, but Tholouli told the BBC she believed more candidates will emerge, and predicted the therapy could ultimately replace stem cell transplantation as a first-line approach.

Prof Peter Johnson, NHS National Clinical Director for Cancer, described the development as a “landmark moment” for people with aggressive blood cancers, adding that it was “remarkable” that a treatment conceived through UK research was now being delivered across the health service. “It will help more people like Oscar live longer and healthier lives.”

The potential of the therapy is already evident in earlier patients. Chris Williams, 29, from Belfast, who was treated in Manchester while the therapy was still experimental, has now been in remission for nearly three years. “A few years ago I was very unwell and now I'm able to live a full life. I was able to go back to work. I also met Chloe and now we're engaged. I have fantastic support from my family and they are over the moon.”

Murphy married his fiancée Lauren at Manchester Royal Infirmary last month, conscious of the uncertainties surrounding his condition, though the couple have planned a second ceremony for October. Looking ahead, his ambitions are disarmingly ordinary. “I want children and the white picket fence with my amazing wife, I just want that normality. This is my gateway to doing it and I can't wait.”