Chimeric antigen receptor T‐cell therapy: Prospective observational study of unplanned emergency department presentations

Abstract

AbstractObjectiveChimeric antigen receptor T‐cell (CAR‐T) therapy is an emerging treatment for refractory hematologic malignancy. Unplanned ED presentations following CAR‐T present the increasing need for an integrated model of care that allows for the early recognition of its specific complications.MethodsThis is a prospective observational study at a tertiary centre. CAR‐T patients (n = 17) were universally enrolled into a study registry by treating providers. These patients were flagged by investigators to trigger a pop‐up notification CAR‐T information warning at ED triage. Medical records were reviewed 90 days for unplanned presentations, complications and patient‐oriented outcomes.ResultsPatients receiving CAR‐T frequently encountered toxicity within 7 days of therapy. This was typically mild and occurred in an inpatient setting. Medical record review revealed five unplanned ED presentations (that were recognised as post CAR‐T) and not directly attributable to specific toxicities.ConclusionIf CAR‐T therapy is to be used more widely especially in an outpatient model of care, a standardised ED model of care for recognition of specific complications is needed.