Can Mental Health Conditions Impact CAR T-Cell Therapy for LBCL Patients?

If you have large B-cell lymphoma (LBCL) and are considering CAR T-cell therapy, learn how pre-existing mental health conditions could affect your treatment experience. Recent research provides important insights, offering both reassurance and practical information.

Why study mental health and CAR-T outcomes?

CAR T-cell therapy has improved outcomes for many patients with relapsed or refractory (R/R) LBCL. However, CAR-T comes with a unique set of potential side effects. Researchers wanted to better understand whether pre-existing mental health disorders, like anxiety or depression, could influence treatment side effects or outcomes.

Given that more people are becoming eligible for CAR-T, understanding all potential risk factors, including mental health, is an important step toward safer, more supportive treatment experiences.

What did the research show about pre-existing mental health and CAR-T for people with LBCL?

Dr. Sushanth Gouni, a second-year fellow from MD Anderson Cancer Center, led research efforts to review the experiences of 441 adults with R/R LBCL who received CAR T-cell therapy between 2018 and 2023. Of these, 153 patients (about 1 in 3) had been previously diagnosed with a mental health condition that required treatment or counseling shortly before starting CAR-T. The results were presented at the 2024 ASH conference. 

Key Findings:

• Patients with a pre-existing mental health diagnosis were more likely to experience severe side effects:
  • Higher rates of severe cytokine release syndrome (CRS)
  • Higher rates of severe neurotoxicity (ICANS), which can cause confusion or other brain-related symptoms
• They were also more likely to require:
  • Intensive care (ICU) during treatment (42% vs. 22% without mental health disorders)
  • Longer hospital stays (over 30 days)
• Patients with mental health disorders needed more medications, like anakinra and corticosteroids, to manage CAR-T side effects

Did mental health affect whether CAR-T worked?

Encouragingly, no. Despite higher rates of severe side effects, patients with mental health conditions had similar response rates and similar survival outcomes compared to those without mental health issues.

This finding is important because it reinforces that patients with mental health conditions can benefit equally from CAR T-cell therapy. 

How to plan for CAR-T if you have a mental health condition.

If you live with a mental health disorder and are considering CAR T-cell therapy for LBCL, this study offers reassuring news: your chances of remission are just as strong as those without mental health conditions.

However, as you have an increased risk of experiencing serious side effects from CAR-T, have open discussions with your care team about your mental health history to help create a personalized strategy for your well-being. 

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Source: 

• Impact of Pre-Existing Mental Health Disorders (MHD) on CAR T-Cell Therapy Outcomes in Patients with Large B-Cell Lymphoma