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Topics:
Hematologic Malignancies • Medical Oncology • Lymphoma • Internal Medicine • Hematology • DLBCL
How do you prepare patients with DLBCL on the potential need for cellular therapies after progression on first line regimens?
When is this discussed? What are the common/less common toxicities you advise patients on? Are there best practices for coordination with referring oncologists?
Answer from: Medical Oncologist at Academic Institution
Once a patient is identified by the lymphoma team, they are referred to our cellular therapy service for full evaluation and discussion of CAR T cell risks, benefits, and logistics. The discussion of protocol versus commercial product, chemotherapy side effects versus CRS/ICANS, and severity includi...
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Answer from: Medical Oncologist at Academic Institution
We discuss the toxicities and logistics of CAR-T as soon as we think a patient may need it. It is important to explain the prolonged manufacturing step, the hospitalization with potential for ICU stay, the need for a caregiver, and the close follow-up in the weeks afterwards.
Answer from: Medical Oncologist at Academic Institution
Most of the patients who are referred to see us have already a relapsed or refractory disease to R-anthracycline based chemotherapy (i.e. R-CHOP), so the discussion about stem cell transplantation and CAR-T therapy starts early. For those who need to be treated promptly with a commercial CAR-T, I in...