Real-World Characterization of Toxicities and Medication Management in Recipients of CAR T-Cell Therapy for Relapsed or Refractory Large B-Cell Lymphoma in Nova Scotia, Canada
Nova Scotia (NS) began offering CAR T-cell therapy as a third-line standard of care for eligible patients with relapsed or refractory large B-cell lymphoma (r/r LBCL) in 2022. Recipients of CAR T-cell therapy often experience acute toxicities, including cytokine release syndrome (CRS) and immune eff...
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MDPI AG
2024-12-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/32/1/2 |
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| author | Jenna Shaw Mahmoud Elsawy Rachel Nielsen Amye Michelle Harrigan Tara T. DiCostanzo Laura V. Minard |
| author_facet | Jenna Shaw Mahmoud Elsawy Rachel Nielsen Amye Michelle Harrigan Tara T. DiCostanzo Laura V. Minard |
| author_sort | Jenna Shaw |
| collection | DOAJ |
| description | Nova Scotia (NS) began offering CAR T-cell therapy as a third-line standard of care for eligible patients with relapsed or refractory large B-cell lymphoma (r/r LBCL) in 2022. Recipients of CAR T-cell therapy often experience acute toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which require close monitoring and prompt management. This retrospective review aimed to describe the characteristics of adult patients with r/r LBCL deemed eligible to receive CAR T-cell therapy with axicabtagene ciloleucel in NS between January 2022 and June 2024, the toxicities experienced and toxicity management, hospital visits and intensive care unit (ICU) admissions, the utilization of toxicity management guidelines, and general efficacy outcomes. Twenty-seven patients received axicabtagene ciloleucel. All patients experienced CRS (7.4% grade ≥ 3), and 55.6% developed ICANS (25.9% grade ≥ 3). The median hospital stay was 18 days, with 40.7% requiring ICU admission. There was one treatment-related mortality. Most CRS (85.2%) and ICANS (80.0%) cases were managed according to the guidelines. By day +100, the best objective response rate was 81.5% (44.4% complete responses). Patients who received CAR T-cell therapy in NS, Canada, experienced comparable toxicities and efficacy to those reported in pivotal clinical trials and other real-world experiences. |
| format | Article |
| id | doaj-art-5c1d4deecb6140909cffacb782e0e82f |
| institution | Kabale University |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-5c1d4deecb6140909cffacb782e0e82f2025-01-24T13:28:19ZengMDPI AGCurrent Oncology1198-00521718-77292024-12-01321210.3390/curroncol32010002Real-World Characterization of Toxicities and Medication Management in Recipients of CAR T-Cell Therapy for Relapsed or Refractory Large B-Cell Lymphoma in Nova Scotia, CanadaJenna Shaw0Mahmoud Elsawy1Rachel Nielsen2Amye Michelle Harrigan3Tara T. DiCostanzo4Laura V. Minard5Department of Pharmacy, Nova Scotia Health, QEII Health Sciences Centre, Halifax, NS B3H 2Y9, CanadaQEII Health Sciences Centre, Division of Hematology and Hematologic Oncology, Dalhousie University, Halifax, NS B3H 4R2, CanadaCell Therapy and Transplant Program, Nova Scotia Health, QEII Health Sciences Centre, Halifax, NS B3H 2Y9, CanadaQEII Health Sciences Centre, Division of Hematology and Hematologic Oncology, Dalhousie University, Halifax, NS B3H 4R2, CanadaDepartment of Pharmacy, Nova Scotia Health, QEII Health Sciences Centre, Halifax, NS B3H 2Y9, CanadaDepartment of Pharmacy, Nova Scotia Health, QEII Health Sciences Centre, Halifax, NS B3H 2Y9, CanadaNova Scotia (NS) began offering CAR T-cell therapy as a third-line standard of care for eligible patients with relapsed or refractory large B-cell lymphoma (r/r LBCL) in 2022. Recipients of CAR T-cell therapy often experience acute toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which require close monitoring and prompt management. This retrospective review aimed to describe the characteristics of adult patients with r/r LBCL deemed eligible to receive CAR T-cell therapy with axicabtagene ciloleucel in NS between January 2022 and June 2024, the toxicities experienced and toxicity management, hospital visits and intensive care unit (ICU) admissions, the utilization of toxicity management guidelines, and general efficacy outcomes. Twenty-seven patients received axicabtagene ciloleucel. All patients experienced CRS (7.4% grade ≥ 3), and 55.6% developed ICANS (25.9% grade ≥ 3). The median hospital stay was 18 days, with 40.7% requiring ICU admission. There was one treatment-related mortality. Most CRS (85.2%) and ICANS (80.0%) cases were managed according to the guidelines. By day +100, the best objective response rate was 81.5% (44.4% complete responses). Patients who received CAR T-cell therapy in NS, Canada, experienced comparable toxicities and efficacy to those reported in pivotal clinical trials and other real-world experiences.https://www.mdpi.com/1718-7729/32/1/2CAR T-cell therapyaxicabtagene ciloleucellarge B-cell lymphomaguideline adherenceguideline utilizationtoxicity management |
| spellingShingle | Jenna Shaw Mahmoud Elsawy Rachel Nielsen Amye Michelle Harrigan Tara T. DiCostanzo Laura V. Minard Real-World Characterization of Toxicities and Medication Management in Recipients of CAR T-Cell Therapy for Relapsed or Refractory Large B-Cell Lymphoma in Nova Scotia, Canada Current Oncology CAR T-cell therapy axicabtagene ciloleucel large B-cell lymphoma guideline adherence guideline utilization toxicity management |
| title | Real-World Characterization of Toxicities and Medication Management in Recipients of CAR T-Cell Therapy for Relapsed or Refractory Large B-Cell Lymphoma in Nova Scotia, Canada |
| title_full | Real-World Characterization of Toxicities and Medication Management in Recipients of CAR T-Cell Therapy for Relapsed or Refractory Large B-Cell Lymphoma in Nova Scotia, Canada |
| title_fullStr | Real-World Characterization of Toxicities and Medication Management in Recipients of CAR T-Cell Therapy for Relapsed or Refractory Large B-Cell Lymphoma in Nova Scotia, Canada |
| title_full_unstemmed | Real-World Characterization of Toxicities and Medication Management in Recipients of CAR T-Cell Therapy for Relapsed or Refractory Large B-Cell Lymphoma in Nova Scotia, Canada |
| title_short | Real-World Characterization of Toxicities and Medication Management in Recipients of CAR T-Cell Therapy for Relapsed or Refractory Large B-Cell Lymphoma in Nova Scotia, Canada |
| title_sort | real world characterization of toxicities and medication management in recipients of car t cell therapy for relapsed or refractory large b cell lymphoma in nova scotia canada |
| topic | CAR T-cell therapy axicabtagene ciloleucel large B-cell lymphoma guideline adherence guideline utilization toxicity management |
| url | https://www.mdpi.com/1718-7729/32/1/2 |
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