Two poster presentations from the Transplantation & Cellular Therapy Meeting of the Center for International Blood & Marrow Transplant Research (CIBMTR) and the American Society for Blood and Marrow Transplantation (ASBMT) held in February 20191,2 reported on trends related to patient-, disease-, treatment-, and cost-related factors for children, young adults, and adults included in a US-based performance improvement clinical database3 who underwent treatment with chimeric antigen receptor T-cell (CAR-T) immunotherapy.

Following the 2017 US Food and Drug Administration (FDA) approval of CAR-T therapy for children, young adult, and adult patients with selected hematologic malignancies, 2 unique ICD10 procedure codes were assigned to CAR-T immunotherapy. These codes provided a means to track patients receiving these treatments in clinical databases.

In both retrospective studies presented at the meeting, data on the characteristics and outcomes of patients receiving CAR-T therapy were obtained for the period between October 2017 and August 2018. The studies included 40 children and young adults younger than 25 years across 20 hospitals, and across 45 hospitals for 735 adults 18 years or older, using the Vizient Clinical Database/Resource Manager.3

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In the cohort of children and young adults, 75%, 20%, 2.5%, and 2.5% had diagnoses of acute lymphoblastic leukemia (ALL), large B-cell lymphoma, blastic natural killer (NK)-cell lymphoma, and acute myoblastic lymphoma, respectively. The median hospital and median ICU stay periods were 17 and 0 days, respectively. The median total cost of hospitalization and the median direct cost were $280,276 and $152,633, respectively.

More than half of patients experienced a treatment-related adverse event during initial hospitalization, and 15.0% of patients had an unplanned readmission to the index hospital within 30 days.

In the cohort of adult patients, cancer types included large B-cell lymphoma (61.5%) other B-cell lymphoma (19.3%), multiple myeloma (4.2%), follicular lymphoma (3.9%), and ALL (1.9%). The median hospital stay period was 15 days. The median total cost of hospitalization and the median direct cost were $82,059 and $43,108, respectively.

Nearly 70% of patients experienced a treatment-related adverse event during initial hospitalization, and 15.9% of patients had an unplanned readmission to the index hospital within 30 days.

References

  1. Hartsell A. Emerging trends in chimeric antigen receptor T-cell immunotherapy in young adults and pediatric patients from the Vizient clinical database. Biol Blood Marrow Transplant. 2019;25(3_Suppl):S337.
  2. Hartsell A. Emerging trends in chimeric antigen receptor T-cell immunotherapy in adults from the Vizient clinical database. Biol Blood Marrow Transplant. 2019;25(3_Suppl):S336-S337.
  3. Vizient. https://www.vizientinc.com/Our-solutions/Clinical-Solutions/Clinical-Data-Base. Accessed March 6, 2019.