Patient Perspectives on Health-Related Quality of Life in Diffuse Large B-Cell Lymphoma Treated with Car T-Cell Therapy: A Qualitative Study

Cheng, Rebecca; Scippa, Kayla; Locke, Frederick L.; Snider, Julia Thornton; Jim, Heather

doi:10.1007/s40487-021-00174-0

Cited by 18 publications

(17 citation statements)

References 56 publications

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“…Worsening in emotional functioning during or immediately after CAR T-cell therapy was also reported in a qualitative study, which was mainly ascribed to concerns about the efficacy of treatment and side effects such as cytokine release syndrome and neurological events. 26 However, by 6 months after treatment, the proportion of patients reporting a concern with emotional impact was reduced by half. 26 A short- and long-term study of patients with lymphomas and other malignancies assessed EORTC QLQ-C30 scores at baseline before transplant and once a week through week 4 after ASCT, once a month from month 6, and once every 6 months for up to 3 years.…”

Section: Discussionmentioning

confidence: 99%

“…Impairment in role functioning and social functioning domains at baseline was consistent with the findings from a qualitative study of HRQOL in patients with diffuse LBCL treated with CAR T-cell therapy. 17,18,26 The burden of treatment between the 2 study arms differed in the duration and sequence of treatments unique to each treatment modality. Notably, patients in the SOC arm continued to receive salvage chemotherapy up to around day 64 and were anticipated to be 2 months after completion of HDCT and ASCT by day 126, while patients in the liso-cel arm had completed lymphodepletion and liso-cel infusion at around study day 29 (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Health-related quality of life with lisocabtagene maraleucel vs standard of care in relapsed or refractory LBCL

et al. 2022

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Lisocabtagene maraleucel (liso-cel) has shown promising efficacy in clinical trials for patients with relapsed/refractory large B-cell lymphoma (LBCL). We present health-related quality-of-life (HRQOL) results from the TRANSFORM study, the first comparative analysis of liso-cel vs standard of care (SOC) as second-line therapy in this population. Adults with LBCL refractory or relapsed ≤12 months after first-line therapy and eligible for autologous stem cell transplantation were randomized 1:1 to the liso-cel or SOC arms (3 cycles of immunochemotherapy where responders proceeded to high-dose chemotherapy and autologous stem cell transplantation). HRQOL was assessed by European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30 items and the Functional Assessment of Cancer Therapy-Lymphoma subscale. Patients with baseline and ≥1 postbaseline assessment were analyzed (liso-cel, n=47; SOC, n=43). The proportion of patients with meaningful improvement in global health status/quality of life (QOL) was higher, while deterioration was lower, in the liso-cel arm vs SOC arm from day 126 to month 6. Mean change scores showed meaningful worsening in global health status/QOL at month 6, fatigue at day 29 and month 6, and pain at month 6 with SOC; mean scores for other domains were maintained or improved in both arms. Time to confirmed deterioration favored the liso-cel arm vs SOC arm in global health status/QOL (median: not reached vs 19.0 weeks, respectively; hazard ratio, 0.47; 95% confidence interval, 0.24‒0.94). HRQOL was either improved or maintained from baseline in patients with relapsed/refractory LBCL in the liso-cel arm vs SOC arm as second-line treatment. This study is registered at clinicaltrials.gov as #NCT0357531.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Health-related quality of life with lisocabtagene maraleucel vs standard of care in relapsed or refractory LBCL

et al. 2022

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“…A similar pattern exists for sleep problems, with over 50% of patients experiencing sleep disruption prior to transplant and up to 43% following discharge home ( 27 , 59 , 64 ). In addition, early work characterizing patient-reported outcomes among patients receiving CAR T cell therapy suggests that fatigue and sleep disruption do not improve even by six months following treatment ( 60 ).…”

Section: Stress-related Biobehavioral Factorsmentioning

confidence: 99%

“…Fatigue and sleep disruption are some of the most prevalent and distressing symptoms experienced by TCT recipients before, during, and after treatment (58)(59)(60). Fatigue tends to be ubiquitous during hospitalization for HCT but may gradually remit for patients during the 100-day post-transplant recovery period.…”

Section: Fatigue and Sleepmentioning

confidence: 99%

Biobehavioral Implications of Covid-19 for Transplantation and Cellular Therapy Recipients

Knight¹,

Taylor²,

Rentscher³

et al. 2022

Front. Immunol.

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A growing body of literature has emphasized the importance of biobehavioral processes – defined as the interaction of behavior, psychology, socioenvironmental factors, and biological processes – for clinical outcomes among transplantation and cellular therapy (TCT) patients. TCT recipients are especially vulnerable to distress associated with pandemic conditions and represent a notably immunocompromised group at greater risk for SARS-CoV-2 infection with substantially worse outcomes. The summation of both the immunologic and psychologic vulnerability of TCT patients renders them particularly susceptible to adverse biobehavioral sequelae associated with the Covid-19 pandemic. Stress and adverse psychosocial factors alter neural and endocrine pathways through sympathetic nervous system and hypothalamic-pituitary-adrenal axis signaling that ultimately affect gene regulation in immune cells. Reciprocally, global inflammation and immune dysregulation related to TCT contribute to dysregulation of neuroendocrine and central nervous system function, resulting in the symptom profile of depression, fatigue, sleep disturbance, and cognitive dysfunction. In this article, we draw upon literature on immunology, psychology, neuroscience, hematology and oncology, Covid-19 pathophysiology, and TCT processes to discuss how they may intersect to influence TCT outcomes, with the goal of providing an overview of the significance of biobehavioral factors in understanding the relationship between Covid-19 and TCT, now and for the future. We discuss the roles of depression, anxiety, fatigue, sleep, social isolation and loneliness, and neurocognitive impairment, as well as specific implications for sub-populations of interest, including pediatrics, caregivers, and TCT donors. Finally, we address protective psychological processes that may optimize biobehavioral outcomes affected by Covid-19.

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Promoting patient-centered care in CAR-T therapy for hematologic malignancy: a qualitative meta-synthesis

Xie,

Duan,

Liu

et al. 2024

Support Care Cancer

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Background CAR-T therapy has emerged as a potentially effective treatment for individuals diagnosed with hematologic malignancies. Understanding patients’ unique experiences with this therapeutic approach is essential. This knowledge will enable the development of tailored nursing interventions that align with the increasing importance of patient-centered care. Objective To examine and synthesize qualitative data on patients and their family caregivers’ experiences during the treatment journey. Design We conducted a systematic review and qualitative meta-synthesis. Eligible studies contained adult patient or family caregiver quotes about experiences of CAR-T therapy, published in English or Chinese in a peer-reviewed journal since 2015. Data sources included MEDLINE, CINAHL, Embase, PsycINFO, Web of Science, Scopus, Cochrane Library, CNKI, and WanFang. Methods Systematic search yielded 6373 identified articles. Of these, 12 reports were included in the analysis, which covered 11 separate studies. Two reviewers independently extracted data into NVIVO 12.0. Qualitative meta-synthesis was performed through line-by-line coding of full text, organization of codes into descriptive themes, and development themes. Results The qualitative meta-synthesis yielded eight primary themes. Noteworthy revelations from patients and their family caregivers regarding the CAR-T therapy journey encompassed various aspects. Prior to CAR-T therapy, patients experienced a lack of actual choice, struggled with expectations for treatment outcomes, and encountered intricate emotional experiences. During or immediately after CAR-T therapy, patients reported both comfortable and uncomfortable experiences. Additionally, patients emphasized that concerns regarding treatment efficacy and adverse reactions intensified treatment-related distress. After CAR-T therapy, significant changes were observed, and the burden of home-based rehabilitation. Additionally, we found factors contributed to the high CAR-T therapy cost. Conclusions To ensure the safety and sustainability of CAR-T therapy, it is crucial to address the physical and psychological aspects of the patient's experience. Effective communication and comprehensive management are highly valued by patients and their caregivers. Further research should investigate ways to reduce burdens and develop self-management education programs for patients and their families. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-024-08799-3.

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Patient Perspectives on Health-Related Quality of Life in Diffuse Large B-Cell Lymphoma Treated with Car T-Cell Therapy: A Qualitative Study

Cited by 18 publications

References 56 publications

Health-related quality of life with lisocabtagene maraleucel vs standard of care in relapsed or refractory LBCL

Health-related quality of life with lisocabtagene maraleucel vs standard of care in relapsed or refractory LBCL

Biobehavioral Implications of Covid-19 for Transplantation and Cellular Therapy Recipients

Promoting patient-centered care in CAR-T therapy for hematologic malignancy: a qualitative meta-synthesis

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