Investigation of treatment invasiveness from the terms of physical function in patients treated with Chimeric antigen receptor-T cell therapy

Abstract

 We conducted a study to investigate the impact of chimeric antigen receptor (CAR)-T cell therapy on the physical function of patients and its invasiveness, which has not been extensively reported. Our study included 58 patients who underwent CAR-T cell therapy and autologous transplantation for diffuse large B-cell lymphoma and multiple myeloma at our hospital between 2014 and 2022. Out of the 26 patients who underwent CAR-T cell therapy, 23 developed cytokine release syndrome (CRS), with a median fever duration of 6 days. Patients with prolonged fever exhibited a decline in performance status at the time of discharge. To measure physical function, we used the 6-minute walk distance (6MWD) test. Before treatment, the 6MWD was lower in patients receiving CAR-T cell therapy than in those undergoing autologous transplantation, and it did not improve significantly after discharge. However, in patients undergoing autologous transplantation, the 6MWD declined significantly from pre- to post-treatment. Our results suggested that autologous transplantation may be more invasive than CAR-T cell therapy when considering the degree of invasiveness of treatment from the perspective of physical function. However, many patients receiving CAR-T cell therapy had poor physical function before treatment, indicating the need for rehabilitation interventions to extend the indications of CAR-T cell therapy to elderly patients and those with a prolonged treatment history.