Andersen Lucy P, Quinn Ryan J, Difilippo Heather, Garfall Alfred L, Porter David L, Meghani Salimah H, Deng Jie
School of Nursing, Biobehavioral Health Sciences, University of Pennsylvania, Philadelphia, Pennsylvania; Johnson and Johnson Innovative Medicine, Raritan, New Jersey.
School of Nursing, Biobehavioral Health Sciences, University of Pennsylvania, Philadelphia, Pennsylvania.
Transplant Cell Ther. 2025 Aug;31(8):592.e1-592.e13. doi: 10.1016/j.jtct.2025.05.013. Epub 2025 May 21.
The long-term financial toxicity for patients who received Chimeric Antigen Receptor (CAR) T-cell therapy and their caregivers remains under-explored. The aim of this research is to describe the financial toxicity of patients who are in remission one to five years after receiving CAR T-cell therapy and their caregivers and explore associations between social determinants of health (SDoH), clinical factors, and health-related quality of life (HRQoL) with financial toxicity. This cross-sectional study included adults who had received CAR T-cell therapy for a hematologic malignancy and their current or former informal caregivers. Patients and caregivers completed measures of financial toxicity, HRQoL, and a demographic survey, while patients also completed cognitive function and symptom burden measures. Descriptive and bivariate statistics were used in this exploratory analysis. There were 58 patients and 31 caregivers study participants. Financial toxicity was relatively low, 25% of patients reported mild to moderate and 18% of caregivers reported mild to severe financial toxicity. Patient financial toxicity was significantly associated with patient income, HRQoL domains, the mental HRQoL summary score, and symptom burden. Caregiver financial toxicity was significantly associated with caregiver age, employment status, HRQoL domains, and the mental HRQoL summary score. Patients and caregivers reported low levels of financial toxicity in the present study: A majority of patients (75%) and caregivers (81%) experienced zero to minimal financial toxicity. Certain patients and caregivers at higher risk for financial toxicity may benefit from targeted interventions coupled with supportive care to address other HRQoL needs.
接受嵌合抗原受体（CAR）T细胞疗法的患者及其护理人员的长期经济毒性仍未得到充分研究。本研究的目的是描述接受CAR T细胞疗法后一至五年缓解期患者及其护理人员的经济毒性，并探讨健康的社会决定因素（SDoH）、临床因素以及与健康相关的生活质量（HRQoL）与经济毒性之间的关联。这项横断面研究纳入了接受过CAR T细胞疗法治疗血液系统恶性肿瘤的成年人及其当前或以前的非正式护理人员。患者和护理人员完成了经济毒性、HRQoL的测量以及一项人口统计学调查，而患者还完成了认知功能和症状负担的测量。在这项探索性分析中使用了描述性和双变量统计。共有58名患者和31名护理人员参与了研究。经济毒性相对较低，25%的患者报告有轻度至中度经济毒性，18%的护理人员报告有轻度至重度经济毒性。患者的经济毒性与患者收入、HRQoL领域、心理HRQoL总结评分以及症状负担显著相关。护理人员的经济毒性与护理人员年龄、就业状况、HRQoL领域以及心理HRQoL总结评分显著相关。在本研究中，患者和护理人员报告的经济毒性水平较低：大多数患者（75%）和护理人员（81%）经历的经济毒性为零至最小。某些经济毒性风险较高的患者和护理人员可能会从针对性干预措施以及支持性护理中受益，以满足其他HRQoL需求。
