Acute patient-reported outcomes in B-cell malignancies treated with axicabtagene ciloleucel

Cancer Med. 2021 Mar;10(6):1936-1943. doi: 10.1002/cam4.3664. Epub 2021 Feb 28.

Abstract

Chimeric antigen receptor T-cell therapy with axicabtagene ciloleucel (axi-cel) has considerably improved survival in adults with relapsed/refractory large B-cell lymphoma. This study reports patient-reported outcomes (PROs) such as quality of life (QOL) and toxicity in the first 90 days after treatment. Hematologic cancer patients treated with axi-cel (N = 103, mean age = 61, 39% female) completed SF-36 or PROMIS-29 QOL questionnaires prior to treatment and 90 days after. PRO-Common Terminology Criteria for Adverse Events toxicity items were completed by patients at baseline and 14, 30, 60, and 90 days after treatment. Mixed models examined change in PROs over time. From preinfusion to 90 days later, patients reported improvements in physical functioning, pain, and fatigue (ps < 0.01), but worsening of anxiety (p = 0.02). Patient-reported toxicities worsened by day 14 with improvement thereafter. The five most severe symptoms at day 14 included fatigue, decreased appetite, dry mouth, diarrhea frequency, and problems with concentration. Results indicate improvement in some domains of QOL over time with transient patient-reported toxicities.

Keywords: behavioral science; hematological cancer; lymphoma; quality of life.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, CD19 / adverse effects
  • Antigens, CD19 / therapeutic use*
  • Anxiety / chemically induced
  • Attention / drug effects
  • Biological Products
  • Diarrhea / chemically induced
  • Fatigue / chemically induced
  • Feeding and Eating Disorders / chemically induced
  • Female
  • Humans
  • Immunotherapy, Adoptive / adverse effects*
  • Lymphoma, Large B-Cell, Diffuse / therapy*
  • Male
  • Middle Aged
  • Pain / chemically induced
  • Patient Reported Outcome Measures*
  • Physical Functional Performance
  • Quality of Life*
  • Time Factors
  • Xerostomia / chemically induced

Substances

  • Antigens, CD19
  • Biological Products
  • axicabtagene ciloleucel