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A Cross-Sectional Study of the Side-Effects Profile and Patient-Doctor Communication about Side Effects in Patients with Lymphoma treated with CAR-T therapy

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Abstract

Results show CAR-T patients have a higher burden of treatment side effects yet are less likely to communicate all of their side effects experienced to their doctor and a number feel they are not receiving enough help from their doctors in coping with side effects. This remains a major concern and a gap in care. Lymphoma Coalition believes that continuous effort should be made to inform and educate patients with lymphoma adequately and appropriately at all points of clinical contact.
INTRODUCTION
Chimeric antigen receptor T-Cell (CAR-T) therapy has revolutionised the
treatment of relapsed and refractory lymphomas, but it has not been
without its attendant side effects and serious complications.
RESULTS CONT.RESULTS
CAR-T patients were significantly different in age group distribution
when compared with non-CAR-T patients (p<0.001) but not in sex
distribution (p=0.81) (Table 1). The two groups also significantly
differed in lymphoma subtypes (p<0.001).
METHODS
Study Design
This study is a sub-analysis of the 2020 LC GPS, which is a biennial
online global survey
The 2020 LC GPS was hosted online on a third-party portal from
January-March 2020 in 19 languages
Study Population
Globally, there were 11,878 respondents made up of 9,179 patients
and 2,699 caregivers from 90+ countries
There were 504 patients included in this analysis
These patients were grouped into 2 subgroups for analysis: patients
who received CAR-T therapy (n=55) and patients who had relapsed
more than once and had not received CAR-T therapy (n=449)
Statistical Analysis
Raw data was entered, merged, and cleaned in IBM SPSSv27
Demographic comparison of the patient subgroups (CAR-T vs non-
CAR-T) was completed
Questions relating to side effects, communication with doctors about
side effects, and help received from doctors for the side effects were
compared using univariate, bivariate and multivariate analysis
CONCLUSIONS
Results show CAR-T patients have a higher burden of treatment side
effects yet are less likely to communicate these to their doctors. Some
of them also feel they are not receiving enough help from their doctors
in coping with side effects. This remains a major concern and a gap in
care.
Lymphoma Coalition believes that continuous effort should be made to
inform and educate patients with lymphoma adequately and
appropriately at all points of clinical contact.
OBJECTIVES
Using the Lymphoma Coalition (LC) 2020 Global Patient Survey (GPS) on
Lymphomas and CLL, this study examines the treatment-related side
effect profile of patients with lymphoma treated with CAR-T therapy in
comparison to patients who have not.
The study also examines if these two patient groups differ in their
communication with doctors about their side effects, or in the help they
receive from doctors for side effects.
A Cross-Sectional Study of the Side Effects Profile and Patient-Doctor Communication
about Side Effects in Patients with Lymphoma treated with CAR-T therapy
Figure 2. How well patients thought their doctors were able to help with their side effects
(CAR-T versus non-CAR-T)
Table 1. Demographic distribution of patients and communication with doctor about
side effects
O. Bamigbola, MB;BS, MSc(Epid)1; N. Dren, BSc, MPH1; and L. Warwick, BA, BEd2.
1Research, Lymphoma Coalition, Mississauga, ON, Canada; 2Management, Lymphoma Coalition, Mississauga, ON, Canada
Figure 1. Top five treatment-related side effects reported by patients with
lymphoma (CAR-T versus non-CAR-T)
Almost one-fifth of those who communicated with their doctors about
side effects (CAR-T-17%; non-CAR-T-20%) felt their doctor was not able
to help with their side effects (Figure 2).
The most prevalent side effects in both groups were fatigue and hair
loss (CAR-T-81% and 83%, respectively; non-CAR-T-68% and 59%).
All the side effects were more prevalent in the CAR-T patients, but the
difference was not significant (Figure 1).
When asked if they communicated with their doctors about their
treatment-related side effects, CAR-T patients were 47% less likely to
answer yes, definitelythan yes, to some extentwhen compared to
the non-CAR-T patients [OR-0.53(0.29-0.98) (p=0.04)] (Table 1).
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