Outpatient administration of CAR T-cell therapies in patients with hematological malignancies

A single-center retrospective analysis reported outcomes of outpatient administration of commercially available chimeric antigen receptor (CAR) T-cell therapies, using a strategy of no remote monitoring and early intervention for cytokine release syndrome (CRS).¹ This analysis included 58 adult patients with hematological malignancies (multiple myeloma, 33; lymphoma, 24; acute lymphoblastic leukemia, 1) who received a commercial CAR T-cell therapy from January 2022 onwards. Results were published in Blood Advances by Furqan et al.¹

In total, 72% of patients were admitted to the hospital in the first 30 days; 40% in Days 0–3, 38% in Days 4–7, and 22% in Days 8–30, with the most common reason for hospitalization being CAR T-cell-related toxicities.

Early outpatient intervention using tocilizumab for Grade ≥1 CRS effectively reduced hospitalization rates, as demonstrated by the 15 out of 35 patients who received tocilizumab for CRSavoiding admission.

The analysis reported a low rate of non-relapse mortality (1.7% at 1 month and 3.4% at 6 months in patients with lymphoma; 0% at 1 and 6 months in patients with multiple myeloma), suggesting that this strategy does not compromise patient safety.

The results suggest that implementing CAR T-cell administration in an outpatient setting is safe and feasible without intensive remote monitoring using an early CRS intervention strategy and may lead to reduced healthcare resource utilization and improved patient quality of life by minimizing hospital admissions.