Synapse - Unscheduled health care interactions in patients with multiple myeloma receiving T-cell redirection therapies

Unscheduled health care interactions in patients with multiple myeloma receiving T-cell redirection therapies Journal Article

Authors:	Howard, A. J.; Concepcion, I.; Wang, A. X.; Hamadeh, I. S.; Hultcrantz, M.; Mailankody, S.; Tan, C.; Korde, N.; Lesokhin, A. M.; Hassoun, H.; Shah, U. A.; Maclachlan, K. H.; Rajeeve, S.; Landau, H. J.; Scordo, M.; Shah, G. L.; Lahoud, O. B.; Chung, D. J.; Giralt, S.; Usmani, S. Z.; Firestone, R. S.
Article Title:	Unscheduled health care interactions in patients with multiple myeloma receiving T-cell redirection therapies
Abstract:	Outcomes for patients with relapsed/refractory multiple myeloma (R/RMM) have dramatically improved after the development and now growing utilization of B-cell maturation antigen-targeted chimeric antigen receptor (CAR) T-cell therapy and bispecific antibody (BsAb) therapy. However, health care utilization as a quality-of-life metric in these growing populations has not been thoroughly evaluated. We performed a retrospective cohort study evaluating the frequency and cause of unscheduled health care interactions (UHIs) among patients with R/RMM responding to B-cell maturation antigen-targeted BsAb and CAR T-cell therapies (N = 46). This included the analysis of remote UHIs including calls to physicians' offices and messages sent through an online patient portal. Our results showed that nearly all patients with R/RMM (89%) receiving these therapies required a UHI during the first 125 days of treatment, with a mean of 3.7 UHIs per patient. Patients with R/RMM responding to BsAbs were significantly more likely to remotely contact their physicians' offices (1.8-fold increase; P = .038) or visit an urgent care center (more than threefold increase; P = .012) than patients with R/RMM responding to CAR T-cell therapies. This was largely due to increased reports of mild upper respiratory tract infections in BsAb patients. Our results underscore the need to develop preemptive management strategies for commonly reported symptoms that patients with R/RMM experience while receiving CAR T-cell or BsAb therapies. This preemptive management may significantly reduce unnecessary health care utilization in this vulnerable patient population. © 2024 by The American Society of Hematology.
Keywords:	adult; controlled study; major clinical study; diarrhea; drug efficacy; outcome assessment; t lymphocyte; interleukin 2; progression free survival; quality of life; multiple myeloma; cohort analysis; cyclophosphamide; retrospective study; fever; health care; health care cost; health care utilization; intensive care unit; hospitalization; total quality management; health care personnel; chimeric antigen receptor; hospital discharge; phase 1 clinical trial; drug therapy; g protein coupled receptor; upper respiratory tract infection; health care facility; cytokine release syndrome; bispecific antibody; human; male; female; article; b cell maturation antigen; medical overuse; chimeric antigen receptor t-cell immunotherapy; trillium
Journal Title:	Blood Advances
Volume:	8
Issue:	12
ISSN:	2473-9529
Publisher:	American Society of Hematology
Date Published:	2024-06-25
Start Page:	3246
End Page:	3253
Language:	English
DOI:	10.1182/bloodadvances.2024012871
PUBMED:	38621239
PROVIDER:	scopus
PMCID:	PMC11226971
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85197209949&doi=10.1182%2fbloodadvances.2024012871&partnerID=40&md5=ea6d09619dd5b1ab7a0412f75b45dc75
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK authors are Saad Z. Usmani and Ross S. Firestone -- Source: Scopus