Journal: Annals of hematology
This study compared health-related quality of life (HRQoL) in patients with relapsed/refractory large B‑cell lymphoma who achieved sustained remission after either CAR T‑cell therapy (tisagenlecleucel) or high‑dose chemotherapy with autologous stem cell transplant (HD‑ASCT).
Design:
- Single-center, consecutive cohort: 28 patients treated between 2019–2023.
- Treatment groups: 15 received CAR T cells; 13 underwent HD‑ASCT.
- Median age: 63.5 years (range 23–73).
- HRQoL assessed with EQ‑5D‑5L and PROMIS‑29 at:
- 12 months post-treatment
- Later time point: median 36.8 months (range 15.7–57.2) after cellular therapy
Key findings:
- At 12 months:
- EQ‑5D‑5L: Index scores were significantly better in the CAR T group (0.89 ± 0.11) vs HD‑ASCT (0.72 ± 0.21; p=0.015).
- PROMIS‑29: Showed clinically meaningful advantages for CAR T recipients across all seven assessed domains (e.g., physical, emotional, and functional aspects), indicating a broader HRQoL benefit.
- At later follow-up (median ~3 years):
- EQ‑5D‑5L: Index values became more similar: 0.82 ± 0.22 (CAR T) vs 0.70 ± 0.25 (HD‑ASCT; p=0.2), suggesting convergence in overall global HRQoL.
- PROMIS‑29: Still showed persistent benefit for CAR T patients in five domains, indicating ongoing advantages in more granular aspects of functioning and well-being despite convergence of the global index.
Clinical implications:
- Short term: For rr LBCL patients achieving long-term remission, CAR T‑cell therapy is associated with superior HRQoL during the first year compared with HD‑ASCT.
- Over time: Some differences narrow, but CAR T recipients maintain advantages in multiple patient-reported domains.
- Practice impact: The results support incorporating longitudinal patient-reported outcomes into treatment selection and counseling for curative-intent therapies in this population.