ArticleBlood advances2024
Optimization of older adults by a geriatric assessment-guided multidisciplinary clinic before CAR T-cell therapy.
Article in Blood advances, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cellular therapy in mantle cell lymphoma: recommendations from the EBMT practice harmonisation and guidelines committee.Bone marrow transplantation · 2026Guideline
- Physical Recovery After CAR-T Cell Therapy vs. Autologous Stem Cell Transplantation Assessed Through Quantitative Rehabilitation Measures.Biomedicines · 2026Article
- Geriatric Assessment in Patients Aged 70 Years and Older Considered for CAR T-Cell Therapy: A Retrospective Study.Cancers · 2026Article
- Review
- Outcomes of patients over 70 years treated with brexu-cel for R/R mantle cell lymphoma: a study from the CTIWP of EBMT.Blood advances · 2026Article
- CD19 CAR T-cell therapy for relapsed/refractory diffuse large B-cell lymphoma in a nonagenarian patient.Journal of clinical and experimental hematopathology : JCEH · 2026Article
- Review
- Article
- Assessing cognitive function in transplantation and chimeric antigen receptor t cell therapy recipients: Expert recommendations from the survivorship, aging and biobehavioral special interest groups of the American Society for Transplantation and Cellular Therapy.Transplantation and cellular therapy · 2025Review
- Moving beyond the eyeball test for fitness assessment in AML.Blood advances · 2025Article
- A SWOT-Consensus for CAR-T in Follicular Lymphoma: Fine Tuning of Patient Journey and Selection.Hematological oncology · 2025Article
- Prophylactic Tocilizumab prior to infusion of CD19 CAR T-cells reduces therapy-related complications in older lymphoma patients.Annals of hematology · 2025Article
- CAR-T cell therapy in older adults with relapsed/refractory LBCL: benefits and challenges.Journal for immunotherapy of cancer · 2025Review
- What to do with the weight while preparing for CAR-T?Blood advances · 2025Article
- Role of Geriatric Assessment in Hematopoietic Stem Cell Transplant and Cellular Therapies.Current treatment options in oncology · 2025Review
- Review
- Review
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
abstractThe optimal means of assessing candidacy of older adults (≥65 years) for chimeric antigen receptor T-cell (CAR-T) therapy are unknown. We explored the role of a geriatric assessment (GA)-guided multidisciplinary clinic (GA-MDC) in selecting and optimizing older adults for CAR-T. Sixty-one patients were evaluated in a GA-MDC (median age, 73 years; range, 58-83). A nonbinding recommendation ("proceed" or "decline") regarding suitability for CAR-T was provided for each patient based on GA results. Fifty-three patients ultimately received CAR-T (proceed, n = 47; decline, n = 6). Among patients who received B-cell maturation antigen (BCMA)-directed (n = 11) and CD19-directed CAR-T (n = 42), the median overall survival (OS) was 14.2 months and 16.6 months, respectively. GA uncovered high rates of geriatric impairment among patients proceeding to CAR-T therapy, with fewer impairments in those recommended "proceed." Patients recommended "proceed" had shorter median length of stay (17 vs 31 days; P = .05) and lower rates of intensive care unit admission (6% vs 50%; P = .01) than those recommended "decline." In patients receiving CD19- and BCMA-directed CAR-T therapy, a "proceed" recommendation was associated with superior OS compared with "decline" (median, 16.6 vs 11.4 months [P = .02]; and median, 16.4 vs 4.2 months [P = .03], respectively). When controlling for Karnofsky performance status, C-reactive protein, and lactate dehydrogenase at time of lymphodepletion, the GA-MDC treatment recommendation remained prognostic for OS (hazard ratio, 3.26; P = .04). Patients optimized via the GA-MDC without serious vulnerabilities achieved promising outcomes, whereas patients with high vulnerability experienced high toxicity and poor outcomes after CAR-T therapy.
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