After CAR-T Cell Therapy, Monitor for These Symptoms at Home

Patients with blood cancers who undergo CAR-T cell therapy will typically stay in the hospital or cancer clinic for a few weeks after therapy so clinicians can monitor for potentially dangerous side effects, such as cytokine release syndrome (a type of overreaction of the immune system) and neurotoxicity.

CAR-T cell therapy, according to the American Cancer Society, is a type of treatment that involves extracting patients’ cells, engineering and growing their immune T cells to find and fight cancer and then re-infusing those new T cells back into the patient.

READ MORE: What Is CAR-T Cell Therapy, and What Can Patients With Cancer Expect?

Once patients return home, there are also symptoms that they and their loved ones should keep an eye out for, such as fever or signs of upper respiratory infections, explained Dr. Nausheen Ahmed.

Ahmed, who is a hematologist-oncologist at the University of Kansas Cancer Center, recently discussed what patients need to know after coming home from CAR-T cell therapy.

Transcript:

There are some patients [who] may have low blood counts, especially neutrophil counts. Our patients will be familiar with that [if] they’re neutropenic. Those patients are at a higher risk of decompensation from any infection. So any fever would be something to report promptly, and ideally get treatment for. Sometimes it might mean IV antibiotics, sometimes it might mean admission. We, at our treatment centers, prefer to avoid the ER so if there's any kind of infrastructure to bypass the ER, that would be great. That's number one.

Then other things can happen such as pneumonia and recurrent respiratory infections. Those have to be promptly reported to the … community oncologist so that they can decide whether the patient needs any other type of medications, antimicrobials for prophylaxis (prevention of conditions) and treatment, whether the patient needs immunoglobulin infusions to help with your immune system, or if there's any other unusual infection that they're worried about … They should be able to either have the patient come back to the treatment center for a visit, or the or the community oncologist can collaborate with the treatment center to see if there's any other testing that needs to be done.

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