Management of Patients undergoing CAR-T cell therapy in Germany.

BACKGROUND

CAR-T cell treatment became standard therapy for relapsed or refractory hematologic malignancies, such as non-hodgkins lymphoma and multiple myeloma. Owing to the rapidly progressing field of CAR-T cell therapy and the lack of generally accepted treatment guidelines, we hypothesized significant differences between centers in prevention, diagnosis and management of short- and long-term complications.

METHODS

To capture the current CAR-T cell management among German centers to determine the medical need and specific areas for future clinical research the DAG-HSZT (Deutsche Arbeitsgemeinschaft für Hämatopoetische Stammzelltransplantation und Zelluläre Therapie ; German Working Group for Hematopoietic Stem Cell Transplantation and Cellular Therapy) performed a survey among 26 German CAR-T cell centers.

RESULTS

We received answers from 17 centers (65%). The survey documents the relevance of evidence in the CAR-T cell field with a homogeneity of practice in areas with existing clinical evidence. In contrast, in areas with no - or low quality - clinical evidence, we identified significant variety in management in between the centers: management of cytokine release syndrome (CRS), immune effector cell related neurotoxicity syndrome (ICANS), IgG substitution, autologous stem cell back-up's, anti-infective prophylaxis and vaccinations.

CONCLUSION

The results indicate the urgent need for better harmonization of supportive care in CAR-T cell therapies including clinical research to improve clinical outcome.

Informations de copyright

The Author(s). Published by S. Karger AG, Basel.