Remission after car t‐cells: do patients recover a normal life?

Introduction: CD19 CAR T-cells can induce prolonged remission in a significant number of patients with relapse/refractory (R/R) lymphoma. However, little is known about patients’ life after CAR T-cell therapy. Here, we conducted a prospective study to evaluate health-related quality of life (HRQol), as well as physical, social and professional outcomes after CAR T-cell therapy. Methods: This prospective study was conducted at the University Hospitals of Rennes and Toulouse (France). All adult patients with R/R lymphoma treated with CAR T-cells were eligible. HRQol changes were assessed using the FACT-Lym questionnaire. Other questionnaires evaluated cognitive state (FACT-Cog), fatigue (FACT-Fatigue), anxiety and depression (HAD scale), post-traumatic stress disorder (PTSD), and sexuality (Vican). Questionnaires were collected at baseline (before leukapheresis), immediately before CAR-T infusion, 3 and 6 months after CAR T-cell infusion. Patients were censored in case of relapse or death. Among patients in remission after 12 months, professional, physical, sexual and global life information were collected. Results: From March 2020 to August 2022, 59 patients were included in the study (46 LBCL, 5 MCL, 8 FL). Median age was 63 years (range, 19–78). Patients were treated with axi-cel (N = 37), tisa-cel (N = 18) or brexu-cel (N = 3). The median follow-up after CAR T-cell infusion was 11 months. There were 53 and 38 still in remission at 3 and 6 months after CAR T-cell infusion, respectively. The FACT-Lym score showed a clinically relevant improvement of HRQol, with a mean change from baseline of 10.9 points (95%CI 5.8; 16.1) and 12.2 (95%CI 4.2; 20.1), respectively. The fatigue subscale showed a clinically relevant improvement at 3 and 6 months, with a mean change from baseline of 5.9 points (95%CI 2.9; 8.8) and 4.7 (95%CI 0.2; 9.2), respectively. The FACT-Cog score did not show any clinically relevant change. The HAD score showed that 43% and 24% of patients presented anxiety and depression at baseline, respectively, versus 26% and 7% after 6 months. Overall, 26% of patients presented a significant PTSD (i.e., >44) at 6 months. 54.5% of the patients considered that their life was back to normal (before lymphoma diagnosis); 68.2% patients were satisfied with their sexual life, 59.1% considered that it was back to normal; 54% felt less fit than before lymphoma; 21/21 patients practicing a physical activity before lymphoma resumed their activity; 3/8 resumed their social activity; Among the working age population (n = 10), 50% patients had returned to work. Encore Abstract - previously submitted to EHA 2023 Keywords: Aggressive B-cell non-Hodgkin lymphoma, Cellular therapies, Other Conflicts of interests pertinent to the abstract F. Colin Consultant or advisory role Gilead, Novartis A. Anota Consultant or advisory role AMGEN, IPSEN, ASTRAZENECA, KITE-GILEAD Educational grants: KITE GILEAD L. Ysebaert Consultant or advisory role AstraZeneca, Beigene, BMS/Celgene, Janssen, Gilead/Kite R. Houot Consultant or advisory role Kite/Gilead Honoraria: Bristol Myers Squibb/Celgene, MSD, Kite/Gilead, Roche, Novartis, Janssen A. Moignet Consultant or advisory role Kite, Novartis