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MPN Workshop of the Carolinas 2025 | Changes in the duration of the monitoring period following CAR T-cell infusion
Tania Jain, MBBS, Sidney Kimmel Comprehensive Cancer Center Johns Hopkins University, Baltimore, MD, comments on the importance of monitoring after CAR T-cell therapy, noting that the traditional four-week monitoring period is being shortened to two weeks. Dr Jain emphasizes the need for ongoing education and proactive management of potential toxicities and infections to avoid deleterious outcomes, highlighting that, while immediate toxicity rates are low, rare toxicities can occur after the two-week window. This interview took place at the 2nd Annual MPN Workshop of the Carolinas, held in Charlotte, NC.
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Transcript
So, I’ll rephrase that question because not everybody needs to be admitted for CAR-T. In fact, we don’t admit anyone preemptively for CAR-T, and many centers are doing that now or have been doing that. But regardless, historically, there’s been this eight-week period where they were not supposed to drive and not lift heavy machinery and so forth. The monitoring period traditionally was four weeks to have them come in – what we were doing was daily for 14 days and then weekly thereafter up until the day 30 scan, and then kind of moving on from there...
So, I’ll rephrase that question because not everybody needs to be admitted for CAR-T. In fact, we don’t admit anyone preemptively for CAR-T, and many centers are doing that now or have been doing that. But regardless, historically, there’s been this eight-week period where they were not supposed to drive and not lift heavy machinery and so forth. The monitoring period traditionally was four weeks to have them come in – what we were doing was daily for 14 days and then weekly thereafter up until the day 30 scan, and then kind of moving on from there. That window is now shortening further to two weeks. And that’s interesting, because while the rates of immediate toxicity is pretty low after 14 days, it’s not zero. And some of the rare toxicities, like IEC-HS and some of the non-ICANS neurotoxicity, especially with the BCMA products, can happen after the two-week window. In fact, most often happen after the two-week window, and that’s something to be mindful of. Similarly with infections, so if we are going to co-manage with a referring oncologist a few hours away, there will need to be an ample amount of education to at least recognize some of these things so that they can be managed proactively and quickly and avoiding any deleterious outcomes.
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Disclosures
Institutional research support from CTI Biopharma, Kartos therapeutics, Incyte, Tscan, Karyopharm Therapeutics; Advisory board participation: Bristol Myers Squibb, Incyte, Abbvie, CTI, Kite, Cogent Biosciences, Blueprint Medicine, Telios pharma, Protagonist therapeutics, Galapagos, Tscan therapeutics, Karyopharm, Morphosys, In8Bio.
