Administering Outpatient CAR T-cell Therapy in Non-Hodgkin Lymphoma | Radhika Bansal, MD | EHA 2024

Hi, my name is Radhika Bansal and I'm from Mayo Clinic Rochester. Our study at Mayo Clinic Rochester assessed the real world trends in outpatient administration of Axicapta gene and Brexucapta gene in patients with relapsed refractory lymphoma. These patients received a standard of care CAR T between 2018 and 2022. Our study also explored differences in amongst patients who were treated in the early phase that is after November 2021 patients received earlier intervention for management of adverse events. And previously there were no defined guidelines so those were called the late management period patients. In our cohort of 155 patients 90% of them were dosed outpatient. There was no increased incidence of adverse events in the patients who were dosed outpatient versus inpatient. However patients in the early management period had a lower incidence of CRS. They had a shorter median duration of time to CRS resolution. They also had a shorter median duration of hospital stay. Next we also explored predictive markers for grade 3 CRS and ICANS. LDH at day zero was associated with increased risk of grade 3 CRS and ICANS. Cause of bridging therapy was associated with early hospital admissions that is within day three of CAR T infusion. Hence our study shows that outpatient administration of CAR T is safe and feasible. Patients in the early management period may have better outcomes and there is an opportunity to further explore this subset of patients. Overall patients getting dosed in the outpatient setting have a further opportunity to improvise their overall outpatient experience by developing predictive markers or models to predict adverse events or time to hospital admission. There is also an opportunity to include digital tools like remote patient monitoring to further escalate patient care in real time. Thank you so much.