Dr Battiwalla on Outpatient CAR T-Cell Therapy Administration in Hematologic Malignancies

Minoo Battiwalla, MD, director, Blood Cancer Outcomes Research, Sarah Cannon Research Institute, discusses preliminary findings from a study evaluating the standardization of outpatient care after CAR T-cell therapy in patients with hematologic malignancies.

Investigators performed a study among sites in the Transplant and Cellular Therapy Network evaluating patient adherence, time spent on monitoring, and clinical outcomes with outpatient care after CAR T-cell therapy administration. Outpatient care was delivered using an FDA-cleared virtual care platform, a wearable device transmitting vital signals, a tablet, an axillary temperature patch, and a blood pressure cuff. Patients also engaged daily with decentralized virtual nurses throughout the duration of the study. Additionally, patients were required to visit the clinic in person during the highest-risk period of CAR T-cell administration, which was days 1 through 14.

In total, 40 patients with non-Hodgkin lymphoma (60%), plasma cell disorder (29%), or acute lymphoblastic leukemia (11%) received CAR T-cell therapy and completed the outpatient CAR T-cell therapy protocol.

This study found the multicentric, standardized approach to care after CAR T-cell therapy administration to be feasible, Battiwalla says. Moreover, in this study, remote patient monitoring was feasible and led to a reduction in the number of days patients spent in the hospital, Battiwalla emphasizes. Patients who received planned inpatient CAR T-cell therapy and subsequent inpatient care required a median of 16 days of hospitalization. Of the patients who received outpatient care after CAR T-cell therapy, 83% required hospitalization, and 28% required admission to the intensive care unit. Among the patients who required hospital observation and/or hospital admission, the median number of days to discharge from the hospital was 4, indicating that outpatient administration decreases hospital resource use, Battiwalla says.

Furthermore, safety was not compromised when patients received outpatient CAR T-cell therapy, Battiwalla explains. A total of 30 patients had no cytokine release syndrome, although 15 of those patients required hospitalization for other reasons.