Remission after CAR T-cell therapy: Do lymphoma patients recover a normal life?

Autor: Perthus A; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France., Colin F; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France., Charton E; Human and Social Sciences Department Leon Berard Center Lyon France., Anota A; Human and Social Sciences Department Leon Berard Center Lyon France.; Department of Clinical Research and Innovation Leon Berard Center Lyon France., Lhomme F; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France., Manson G; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France., De Guibert S; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France., Daufresne P; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France., Bellec A; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France., Le Bars L; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France., De Barros S; Department of Hematology Cancer University Institute of Toulouse Oncopole Toulouse France., Ysebaert L; Department of Hematology Cancer University Institute of Toulouse Oncopole Toulouse France., Merceur M; Department of Physical and Rehabilitation Medicine University Hospital of Rennes Rennes France., Cogné M; Department of Physical and Rehabilitation Medicine University Hospital of Rennes Rennes France., Lamy De La Chapelle T; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France.; UMR U1236, INSERM University of Rennes Rennes France., Houot R; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France.; UMR U1236, INSERM University of Rennes Rennes France., Moignet A; Service d'Hématologie-CHU Pontchaillou, Department of Hematology University Hospital of Rennes Rennes France.
Jazyk: angličtina
Zdroj: HemaSphere [Hemasphere] 2024 May 27; Vol. 8 (5), pp. e72. Date of Electronic Publication: 2024 May 27 (Print Publication: 2024).
DOI: 10.1002/hem3.72
Abstrakt: Chimeric antigen receptor T cells (CAR T cells) can induce prolonged remission in a substantial subset of patients with relapse/refractory lymphoma. However, little is known about patients' life after CAR T-cell therapy. We prospectively assessed the multidimensional recovery of lymphoma patients in remission, before leukapheresis, before CAR T-cell infusion, and 3, 6, and 12 months thereafter. Validated tools were used to measure lymphoma-related and global health-related quality of life (HRQoL; Functional Assessment of Cancer Therapy-Lymphoma [FACT-Lym] and EQ-5D-5L), cognitive complaint (FACT-Cognition), fatigue (FACIT-Fatigue subscale), psychological status (Hospital Anxiety and Depression Scale, Post-Traumatic Check List Scale), and sexuality (Relationship and Sexuality Scale). Beyond 12 months of remission, we also surveyed physical, professional, sexual, and general life status. At 3, 6, and 12 months, 53, 35, and 23 patients were evaluable, respectively. Improvement in lymphoma-related HRQoL was clinically relevant at 3, 6, and 12 months with a mean change from baseline of 10.9 (95% confidence interval [CI]: 5.8; 16.1), 12.2 (95% CI: 4.2; 20.1), and 11.72 (95% CI: 2.06; 21.38), respectively. Improvement in global HRQoL, fatigue, and anxiety was clinically relevant, but 20%-40% of patients experienced persistent fatigue, psychological distress, and cognitive complaints over time. Beyond 12 months after CAR T cells, 81.8% of 22 evaluable patients were satisfied with their daily life. Physical activity, professional, sexual, and global well-being had returned to prediagnosis levels in nearly half of the patients. We found an improvement in HRQoL after CAR T-cell therapy including anxiety, depression, sexual satisfaction, and general well-being. However, not all patients recover a "normal life." Further research is needed to determine which patients are at risk of quality-of-life impairment to improve recovery after CAR T-cell infusion.
Competing Interests: The authors report the following competing interests: Aline Moignet: Honoraria from Kite/Gilead. Fanny Colin: Honoraria from Kite/Gilead. Roch Houot: Honoraria from Kite/Gilead, Novartis, Incyte, Janssen, MSD, Takeda and Roche; and consultancy at Kite/Gilead, Novartis, Bristol‐Myers Squibb/Celgene, ADC Therapeutics, Incyte, Miltenyi. Amélie Anota: Consultancy for Amgen, Ipsen, AstraZeneca, Kite/Gilead. Guillaume Manson: Honoraria from Chugai, Kite/Gilead, Takeda. Loïc Ysebaert: Consultancy at Beigene, Bristol‐Myers Squibb/Celgene, Janssen, Kite/Gilead, and Roche, and is on the speaker's bureau of AstraZeneca. Sophie De Guibert: Honoraria from Kite/Gilead and Novartis.
(© 2024 The Authors. HemaSphere published by John Wiley & Sons Ltd on behalf of European Hematology Association.)
Databáze: MEDLINE
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