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Allogeneic hematopoietic cell transplantation vs standard consolidation chemotherapy in patients with intermediate-risk acute myeloid leukemia: a randomized clinical trial (2023)
Bornhäuser, Martin ; Schliemann, Christoph ; Schetelig, Johannes ; Röllig, Christoph ; Kramer, Michael ; Glass, Bertram ; Platzbecker, Uwe ; Burchert, Andreas ; Hänel, Mathias ; Müller, Lutz P. ; Klein, Stefan ; Bug, Gesine ; Beelen, Dietrich ; Rösler, Wolf ; Schäfer-Eckart, Kerstin ; Schmid, Christoph ; Jost, Edgar ; Lenz, Georg ; Tischer, Johanna ; Spiekermann, Karsten ; Pfirrmann, Markus ; Serve, Hubert ; Stölzel, Friedrich ; Alakel, Nael ; Middeke, Jan Moritz ; Thiede, Christian ; Ehninger, Gerhard ; Berdel, Wolfgang E. ; Stelljes, Matthias
Management of patients undergoing CAR-T cell therapy in Germany (2024)
Penack, Olaf ; Dreger, Peter ; Ajib, Salem ; Ayuk, Francis ; Baermann, Ben-Niklas ; Bug, Gesine ; Kriege, Oliver ; Jentzsch, Madlen ; Kobbe, Guido ; Koenecke, Christian ; Lutz, Mathias ; Martin, Sonja ; Schlegel, Paul-Gerhard ; Schroers, Roland ; von Tresckow, Bastian ; Vucinic, Vladan ; Subklewe, Marion ; Bethge, Wolfgang ; Wolff, Daniel
Introduction: Chimeric antigen receptor positive T cell (CAR-T cell) treatment became standard therapy for relapsed or refractory hematologic malignancies, such as non-Hodgkin’s lymphoma and multiple myeloma. Owing to the rapidly progressing field of CAR-T cell therapy and the lack of generally accepted treatment guidelines, we hypothesized significant differences between centers in the prevention, diagnosis, and management of short- and long-term complications. Methods: To capture the current CAR-T cell management among German centers to determine the medical need and specific areas for future clinical research, the DAG-HSZT (Deutsche Arbeitsgemeinschaft für Hämatopoetische Stammzelltransplantation und Zelluläre Therapie; German Working Group for Hematopoietic Stem Cell Transplantation and Cellular Therapy) performed a survey among 26 German CAR-T cell centers. Results: We received answers from 17 centers (65%). The survey documents the relevance of evidence in the CAR-T cell field with a homogeneity of practice in areas with existing clinical evidence. In contrast, in areas with no – or low quality – clinical evidence, we identified significant variety in management in between the centers: management of cytokine release syndrome, immune effector cell-related neurotoxicity syndrome, IgG substitution, autologous stem cell backups, anti-infective prophylaxis, and vaccinations. Conclusion: The results indicate the urgent need for better harmonization of supportive care in CAR-T cell therapies including clinical research to improve clinical outcome.
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