Prospective Assessment of Quality of Life and Patient-Reported Toxicities Over the First Year After Chimeric Antigen Receptor T-Cell Therapy.

Autor: Hoogland AI; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida. Electronic address: aasha.hoogland@moffitt.org., Barata A; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts., Li X; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Irizarry-Arroyo N; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Jain MD; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Welniak T; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Rodriguez Y; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Oswald LB; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Gudenkauf LM; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Chavez JC; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Khimani F; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Lazaryan A; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Liu HD; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Nishihori T; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Pinilla-Ibarz J; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Shah BD; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Crowder SL; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Parker NH; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Carson TL; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Vinci CE; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida., Pidala JA; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Logue J; Moffitt Malignant Hematology & Cellular Therapy, Memorial Healthcare System, Pembroke Pines, Florida., Locke FL; Department of Blood and Marrow Transplantation and Cellular Therapy, Moffitt Cancer Center, Tampa, Florida., Jim HSL; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida.
Jazyk: angličtina
Zdroj: Transplantation and cellular therapy [Transplant Cell Ther] 2024 Dec; Vol. 30 (12), pp. 1219.e1-1219.e11. Date of Electronic Publication: 2024 Sep 19.
DOI: 10.1016/j.jtct.2024.09.013
Abstrakt: Chimeric antigen receptor (CAR) T-cell therapy has transformed survival outcomes in patients with relapsed and refractory large B-cell lymphoma (LBCL), but it is associated with a variety of side effects. This study examined changes in patient-reported quality of life (QoL) and toxicities, as well as risk factors for worse QoL and toxicities, in the first year after treatment. Patients with LBCL completed questionnaires assessing QoL and toxicity severity before infusion, and 90, 180, and 360 days after infusion. Mixed models were used to examine changes in QoL and toxicities over time, and clinical moderators of change in QoL and toxicities. Patients reported improvements in physical functioning and fatigue in the year after treatment (P values <.01), but there were no changes in pain, anxiety, or depression over time. Patients with active disease at day 90 reported more physical dysfunction at all postinfusion timepoints (Ps ≤ .01) compared to patients who responded to treatment. Similarly, patients with active disease at day 90 reported worsening depression over time, such that at day 360, depressive symptoms were worse for patients with active disease than patients without active disease (P = .02). Patients treated with 4+ lines of prior therapy reported worsening pain and anxiety over time, such that at day 360, both pain and anxiety were significantly worse for patients previously treated with 4 of more lines of therapy than patients treated with fewer lines of therapy (Ps ≤ .01). Regarding toxicities, patients reported decreasing overall toxicity burden up to day 180, with subsequent worsening at day 360 (P = .02). Most patients reported at least one or two grade 2 toxicities at each timepoint. Patients demonstrated unchanging or improved QoL after treatment with CAR T-cell therapy, but active disease and greater prior lines of therapy were associated with worse QoL outcomes over time. Toxicity severity also improved during the first 6 months post-treatment, but worsened thereafter, particularly among patients with active disease after treatment.
(Copyright © 2024 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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