Health Care Resource Utilization Among Patients With DLBCL

Data from the ASCO 2021 meeting suggests patients with diffuse large b-cell lymphoma (DLBCL) treated with CAR-T therapy in the outpatient setting had a lower number of inpatient and intensive care unit (ICU) visits compared with patients receiving CAR-T therapy in the inpatient setting.

“While majority of the CAR-T infusions occur at inpatient setting in clinical trials, CAR-T infusions can also occur in the outpatient setting,” explained the researchers. “This study aimed to compare the real-world HRU between IP vs. OP infusion of CAR-T among patients with relapsed/refractory (R/R) DLBCL.”

For the study, adult patients with R/R DLBCL receiving either axicabtagene ciloleucel or tisagenlecleucel were selected. They were placed into an inpatient or outpatient cohort based on CAR-T infusion setting.

The researchers compared the number of inpatient, outpatient, and ICU visits, as well as inpatient days and ICU days by month post-CAR-T infusion among each cohort. They used linear models and adjusted for age, sex, race, and National Cancer Institute comorbidity index. Finally, the average length of stay per inpatient episode during the first month of treatment was also observed.

Based on the criteria, 430 patients who received CAR-T therapy were identified, of which 380 (mean age 70.8 years) were in the inpatient setting and 50 (mean age 68.4 years) in the outpatient setting. More specifically, in the outpatient setting, 90.2% received tisagenlecleucel and 9.8% received axicabtagene ciloleucel.

According to the findings, during the first month following the CAR-T infusion, the outpatient cohort had a lower number of inpatient visits and days as well as ICU stays compared to the inpatient cohort. The average length of stay per inpatient episode was 14.2 days in the inpatient cohort and 7.1 days within the outpatient cohort.

In conclusion, the findings of the study show that the number of inpatient visits, inpatient days, and ICU days were much lower in the outpatient cohort, while the number of outpatient visits were higher in the outpatient cohort compared to the inpatient cohort in subsequent months.

“Patients receiving CAR-T in the [outpatient] setting had lower resource use of [inpatient] and ICU compared to patients receiving CAR-T in the [inpatient] setting,” concluded the authors.