Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Stem Cell and Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Transplant Cell Ther. 2021 May;27(5):390.e1-390.e7. doi: 10.1016/j.jtct.2021.01.003. Epub 2021 Jan 7.
Databases were searched to identify studies published over the past 10 years that addressed the utility of patient-reported outcomes (PROs) in patients receiving chimeric antigen receptor (CAR) T cell therapy in patients with hematological malignancies. Among 280 records, three articles covering 206 patients were eligible. The data were prospectively collected at multiple time points. The compliance rates were 70% to 94%. There was an inverse relationship between fatigue and social function among adults. The quality of life (QoL) improvement and ability to complete PROs were linked to disease status. About 40% of adults reported at least some cognitive difficulties, with a detrimental impact on mental and physical health status. In adults, the most commonly reported cognitive impairment was memory difficulties. Depression was associated with cognitive difficulties. Younger adults were at higher risk of long-term poor mental health, anxiety, and depression. For pediatric and adolescent patients, emotional dysfunction improves over time. QoL status improved over time; yet, severe cytokine release syndrome and neurotoxicity caused delayed improvement. Information regarding whether the PROs were integrated into medical records and clinical guidelines is lacking. Utilizing PROs in patients on CAR T cell therapy seems feasible and informative. Studies utilizing larger sample sizes and using validated PRO tools at different time points remain unmet needs.
检索数据库，以确定过去 10 年中发表的研究，这些研究探讨了患者报告结局（PROs）在接受嵌合抗原受体（CAR）T 细胞治疗血液系统恶性肿瘤患者中的应用。在 280 篇记录中，有 3 篇涵盖 206 例患者的文章符合条件。数据是在多个时间点前瞻性收集的。依从率为 70%至 94%。成年人的疲劳和社会功能之间呈负相关。生活质量（QoL）的改善和完成 PROs 的能力与疾病状态有关。约 40%的成年人报告至少存在一些认知困难，对身心健康状况有不利影响。在成年人中，最常见的认知障碍是记忆力困难。抑郁与认知困难有关。年轻成年人患长期精神健康不良、焦虑和抑郁的风险更高。对于儿科和青少年患者，情绪功能障碍随时间改善。QoL 状况随时间改善；然而，严重的细胞因子释放综合征和神经毒性导致改善延迟。关于 PROs 是否被纳入病历和临床指南的信息尚不清楚。在接受 CAR T 细胞治疗的患者中使用 PROs似乎是可行且有益的。仍需要使用更大的样本量和在不同时间点使用经过验证的 PRO 工具进行研究。
