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Bijal Shah, MD, MS, and Michael Wang, MD, discuss the need for collaboration between academic and community practices for patients who receive CAR T-cell therapy.
Bijal Shah, MD, MS, associate member, Department of Malignant Hematology, Moffitt Cancer Center, and Michael Wang, MD, professor, Department of Lymphoma & Myeloma, The University of Texas MD Anderson Cancer Center, discuss the need for collaboration between academic and community practices for patients who receive CAR T-cell therapy.
Integrating primary care physicians into the post–CAR T-cell therapy management of patients with hematologic malignancies is difficult, Shah and Wang explain. In many cases, engaging community practices has not been a priority; however, primary care physicians can closely monitor heart function and recovery of immunoglobulin while supporting the patient.
Gaps in communication still exist, particularly when patients come into the emergency room with CAR T-cell therapy–related complications, such as infections. Moreover, these gaps have been further exacerbated with the onset of the COVID-19 pandemic, Wang says.
Aggressive treatments with vaccines, IVIG, and prophylactic antibodies for patients who develop infections after CAR T-cell therapy are helpful, but managing patients who develop CAR T-cell therapy–related complications away from the center in which they received CAR T-cell therapy is challenging. Furthermore, this underscores the need for close collaborations and partnerships between academic and community practices, Shah concludes.