Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA.
Vanderbilt University Medical Center, Department of Medicine, Division of Hematology/Oncology, Nashville, TN, USA.
Cancer Med. 2021 Mar;10(6):1936-1943. doi: 10.1002/cam4.3664. Epub 2021 Feb 28.
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.
嵌合抗原受体 T 细胞疗法(axicabtagene ciloleucel,axi-cel)显著改善了复发/难治性大 B 细胞淋巴瘤成人患者的生存。本研究报告了治疗后 90 天内患者报告的结局(PROs),如生活质量(QOL)和毒性。接受 axi-cel 治疗的血液系统恶性肿瘤患者(N=103,平均年龄 61 岁,39%为女性)在治疗前和治疗后 90 天完成了 SF-36 或 PROMIS-29 QOL 问卷。PRO-常见不良事件术语标准毒性项目由患者在基线和治疗后 14、30、60 和 90 天完成。混合模型分析了 PROs 随时间的变化。从输注前到 90 天后,患者报告身体功能、疼痛和疲劳有所改善(p<0.01),但焦虑加重(p=0.02)。从第 14 天开始,患者报告的毒性恶化,此后逐渐改善。第 14 天最严重的五种症状包括疲劳、食欲下降、口干、腹泻频率和注意力问题。结果表明,随着时间的推移,QOL 的某些领域有所改善,同时伴有短暂的患者报告毒性。