Study Examines QoL, Depression After CAR-T for Hematologic Malignancy

For patients with hematologic malignancies, 18, 22, and 22 percent have clinically significant depression, anxiety, PTSD at six months

By Elana Gotkine HealthDay Reporter

FRIDAY, April 7, 2023 (HealthDay News) — For adults with hematologic malignancies receiving chimeric antigen receptor T-cell (CAR-T) therapy, quality of life (QoL) deteriorates and physical and psychological symptoms worsen one week after infusion and then improve by six months postinfusion, according to a study published recently in Blood Advances.

Patrick Connor Johnson, M.D., from Massachusetts General Hospital in Boston, and colleagues examined QoL, psychological distress, and physical symptoms at baseline, one week, one month, three months, and six months after CAR-T infusion among adults with hematologic malignancies. A total of 100 patients were enrolled between April 2019 and November 2021.

The researchers found that by one week, there was a worsening in QoL and depression symptoms, followed by improvement by six months after CAR-T therapy. Clinically significant depression, anxiety, and posttraumatic stress disorder symptoms were reported by 18, 22, and 22 percent of patients, respectively, at six months. Fifty-two percent of patients noted severe physical symptoms at one week, which declined to 28 percent at six months post-CAR-T therapy. In unadjusted models, associations with a higher QoL trajectory were seen for worse Eastern Cooperative Oncology Group performance, receipt of tocilizumab, and receipt of corticosteroids for cytokine release syndrome and/or immune effector cell-associated neurotoxicity syndrome.

“Here we show significant improvements in quality of life among patients with an array of blood cancer diagnoses, receiving a variety of CAR-T products,” Johnson said in a statement. “However, we also identify a distinct subset of patients who have persistent physical and psychological symptom burden, even at the six-month post-CAR-T time point.”

Several authors disclosed pharmaceutical industry ties.