CAR T-cell recipients receive more psychological support, fear cancer progression less
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Patients who received chimeric antigen receptor T cells for relapsed or refractory diffuse large B-cell lymphoma feared disease progression less than those who received standard regimens, results of a cross-sectional study showed.
However, CAR-T recipients more often received psychosocial support and education for depression, anxiety and fear than those treated with standard regimens for DLBCL, according to data presented at European Society for Blood and Marrow Transplantation-European Hematology Association 5th European CAR T-cell Meeting.
“The potential inequity in patient support highlights an opportunity for improvement in the provision of interventions that can support the psychosocial experiences of those with relapsed or refractory diffuse large B-cell lymphoma,” Natacha Bolaños, head of membership and alliances at Lymphoma Coalition, said during a presentation.
Background and methodology
The biennial Lymphoma Coalition Global Patient Survey provides insights into the psychosocial experiences of patients with lymphomas and chronic lymphocytic leukemia.
The most recent survey — conducted online from February to April 2022 — included 8,637 respondents (patients, n = 7,113; caregivers, n = 1,524) from 84 countries.
Bolaños and colleagues used survey data to evaluate differences in patient experiences between those who received CAR-T and those who received other treatment regimens.
The investigators analyzed psychological survey data from a subgroup of 204 patients diagnosed with relapsed or refractory DLBCL. The subgroup included 28 patients who received CAR-T and 176 who received other regimens.
Incidence of self-reported psychosocial issues with the past year — including depression, anxiety, fear and communication — served as the study’s primary outcome measurement.
Key findings
Investigators reported comparable incidence of depression (28.6% for CAR-T vs. 32.7% for other regimens) and anxiety (46.4% for CAR-T vs. 44.6% for other regimens).
Fewer patients who received CAR-T expressed fear about disease progression (36% vs. 51.6%). However, a higher percentage treated with CAR-T reported fear of disease relapse (75% vs. 61.6%).
“The difference here could be how patients are told to think about their disease or the current status of their disease,” Bolaños said.
CAR-T recipients appeared more likely to receive support from a physician for depression (100% vs. 71%) or anxiety (86% vs. 73%) than those who received other regimens.
Researchers noted more frequent education regarding depression, anxiety and fear offered to CAR-T recipients from health care staff and caregivers, in addition to more frequent support. Notably, 32% of CAR-T recipients reported their physician followed-up about psychological issues raised compared with 15% who received other regimens.
Clinical implications
Further study with a larger number of CAR-T recipients is required to confirm these findings, Bolaños said.
“Those receiving CAR-T receive more support, which may be due — in part — to the fact that [this] newer therapy was more likely delivered thorough a clinical trial and requires more intense follow-up than standard of care,” Bolaños said.
Another reason why CAR-T recipients are more likely to be offered and accept support for depression and anxiety is that treatment protocols may require that care be provided by a multidisciplinary team that includes a variety of health care professionals who may not be available at centers providing other standard regimens for lymphoma, she added.
“The results highlight an opportunity for all patients to be offered the same level of care,” Bolaños said. “Follow-up for any support offer of psychosocial issues is needed to ensure that recommended interventions are working.”
Collapse
Warwick L, et al. Abstract BA02-6. Presented at: European Society for Blood and Marrow Transplantation-European Hematology Association 5th European CAR T-cell Meeting; Feb. 9-11, 2023; Rotterdam, Netherlands.
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