Comprehensive Assessment for CAR T-Cell Therapy in Large B-Cell Lymphoma

Dr. Shah describes the clinical and functional assessments he uses when evaluating patients with large B-cell lymphoma for CAR T-cell therapy. He emphasizes the value of an overall assessment of functional status, activity level, comorbidities, and how the patient appears and functions in the clinical setting, while noting that geriatric consultation can provide additional information when needed. Standard evaluations, including echocardiography and pulmonary function testing, help identify organ dysfunction that may require specialist input or optimization before treatment. Dr. Shah explains that his team uses available multidisciplinary resources, including physical therapy and social, financial, and organ-specific support, to address potentially modifiable risks rather than relying on a single exclusion criterion. He also discusses the evolution of CAR T-cell toxicity management, highlighting earlier intervention and prophylactic approaches to help reduce complications. The discussion then returns to Mr. R, with Dr. Perales and Dr. Shah agreeing that his age, functional status, comorbidities, and caregiver support would make him an appropriate candidate for CAR T-cell therapy based on the information available.