|The following article features coverage from the 2021 American Society of Hematology Annual Meeting. Click here to read more of Cancer Therapy Advisor’s conference coverage.|
In a real-world study, 45% of patients were rehospitalized within the first year of receiving chimeric antigen receptor (CAR) T-cell therapy, and 67% of rehospitalizations occurred in the first month after treatment.
These results were presented at the 2021 American Society of Hematology (ASH) Annual Meeting by Kelly Kenzik, PhD, of the University of Alabama at Birmingham.
Dr Kenzik and colleagues used the MarketScan database to identify 211 patients with commercial insurance who had received CAR T-cell infusions from September 1, 2017, to December 31, 2019. All patients were younger than 65 years.
Patients had B-cell lymphoma (68.3%), chronic lymphocytic leukemia (7.6%), and other cancers (24.2%). The median follow-up was 6 months.
There were a total of 209 rehospitalizations. Within 12 months of CAR T-cell infusion, 45% of patients were rehospitalized. Within 3 months, 34% of patients were rehospitalized.
Among rehospitalized patients, 47% had 1 hospitalization, 24% had 2 hospitalizations, and 29% had 3 or more hospitalizations.
The median time to the first rehospitalization was 42 days (range, 1-321 days), and 67% of rehospitalizations occurred within the first month of CAR T-cell infusion.
The rate of rehospitalization was 0.66 per patient-month within the first 30 days, but it declined to 0.11 per patient-month from 31 days to 90 days. Over 12 months, the average was 0.23 per patient-month.
The most common reasons for hospitalization were primary disease (57%) and infection (33%). The cumulative incidence at 12 months for cause-specific hospitalizations was 34% for primary disease, 18.2% for infection, and 6.7% for other reasons.
Nearly one-quarter (23%) of patients had an emergency department (ED) visit after CAR T-cell infusion. The majority (71%) had 1 visit, 18% had 2 ED visits, and 10% had 3 or more visits.
The most common reasons for ED visits were primary disease (42%), infection (18.1%), and pain (8.6%). The median time to ED visit was 70 days (range, 1-340 days).
There were 71 total ED visits, and 13 occurred within the first month after CAR T-cell infusion.
“Our real-world data found that 45% of patients were rehospitalized, and 23% were seen in the ED at least once in the first 12 months,” Dr Kenzik said. “The risk for both is highest within the first month from infusion.”
Dr Kenzik acknowledged that this study is limited by the use of administrative data, as the data provide limited details on patients’ prior conditions, disease status, and treatment.
“There’s much future work to be done to better understand these high-risk groups to help inform risk mitigation strategies,” Dr Kenzik said.
Read more of Cancer Therapy Advisor’s coverage of the ASH 2021 meeting by visiting the conference page.
Kenzik K, Johnson PC, Bhatia S. Hospitalizations and emergency department (ED) visits after CAR-T therapy – Real world experience in commercially insured patients. Presented at ASH 2021; December 11-14, 2021. Abstract 569.