A Cross-Sectional Study of Psychosocial Experiences in Patients with Relapsed/Refractory Diffuse Large B Cell (DLBCL) Who Received CAR-T Compared to Other Therapies
Authors: C. Bates¹, S. Kalloger¹, A. Watson¹, L. Warwick¹
¹Lymphoma Coalition, Mississauga, Canada
Topic: Patient Advocacy Data
Short Title
Psychosocial experiences in patients receiving CAR-T compared to other therapies
Background
Chimeric antigen receptor T-cell (CAR-T) therapy continues to expand as a treatment option for patients with relapsed/refractory diffuse large B cell lymphoma (DLBCL). This study provides insight into the psychosocial experiences of patients with relapsed and refractory DLBCL treated with CAR-T compared to other therapies.
Methods
- Survey Population:
- Total respondents: 8,637
- Patients: 7,113
- Caregivers: 1,524
- Countries: 84
- Survey: 2022 Lymphoma Coalition Global Patient Survey (GPS)
- Subgroup Analysis:
- Diagnosed with DLBCL: 996
- Classified as relapsed/refractory disease: 204
- Received CAR-T treatment: 28
- Received non-CAR-T regimens: 176
- Focus:
Survey questions related to psychological experiences (depression, anxiety, fear, communication) were analyzed for both patient groups.- Differences in proportions tested using Fisher’s Exact Test.
Flow of Participants
- Total Respondents (N=8637)
→ Diagnosed with DLBCL (N=996)
→ Excluded (N=7641) - Classified as Relapsed/Refractory (N=204)
→ Excluded (N=792) - Treated with CAR-T (N=28)
- Treated with Other Therapies (N=176)
Results
- Depression:
Similar incidence between CAR-T (28%) and non-CAR-T (32%). - Anxiety:
Similar between groups (CAR-T: 46%, Others: 44%). - Fear of Progression:
Higher in those who received non-CAR-T therapies. - Support and Education:
Patients receiving CAR-T more frequently received psychosocial support and education for depression, anxiety, and fear from healthcare teams and caregivers. - Communication:
Communication between doctors and patients was over twice as prevalent in CAR-T (31%) compared to non-CAR-T (15%).
Table 1. Psychosocial Support and Experiences
| Psychosocial Measure | CAR-T | Other Therapies | P-value |
|---|---|---|---|
| Received written/oral information for depression | 3/5 (60%) | 0/21 (0.0%) | 0.004 |
| Received medications to help with depression | 5/5 (100%) | 11/21 (52.4%) | 0.05 |
| Received education/support group for depression | 3/5 (60%) | 4/21 (19.1%) | 0.1 |
| Doctor was able to help (with anxiety) | 6/7 (85.7%) | 29/40 (72.5%) | 0.7 |
| Received written/oral information for anxiety | 3/6 (50%) | 3/28 (10.7%) | 0.05 |
| Received empathetic understanding from nurse | 3/6 (50%) | 2/28 (7.1%) | 0.03 |
| Pursued exercise (for fear) | 4/6 (66.7%) | 11/42 (26.2%) | 0.1 |
| Doctor was able to help with fear of relapse | 12/16 (75.0%) | 37/49 (75.5%) | 1.0 |
| Communication / Doctor follow-up | 6/19 (31.6%) | 14/94 (14.9%) | 0.1 |
Conclusions
- Patients who received CAR-T reported greater access to psychosocial support compared to those who received other non-CAR-T regimens.
- The disparity may be partly due to CAR-T being a newer therapy, often delivered through clinical trials, requiring more intensive follow-up than standard care.
- The inequity in psychosocial support for novel therapeutics highlights the need for improved interventions to support patients with relapsed and refractory DLBCL.
- Future research should include larger sample sizes to strengthen these findings.
Summary
This cross-sectional study compared the psychosocial experiences of patients with relapsed/refractory diffuse large B cell lymphoma (DLBCL) who received CAR-T therapy versus other treatments.
- Study Population:
- 8,637 survey respondents from 84 countries
- 204 patients with relapsed/refractory DLBCL
- 28 treated with CAR-T, 176 with other therapies
- Key Findings:
- Depression & Anxiety: Similar rates between CAR-T and non-CAR-T groups.
- Fear of Progression: Higher in non-CAR-T patients.
- Support & Education: CAR-T patients received more frequent psychosocial support and education from healthcare teams and caregivers.
- Communication: More than twice as common between doctors and CAR-T patients compared to non-CAR-T patients (31% vs. 15%).
- Conclusion:
CAR-T patients had greater access to psychosocial support, likely due to the intensive monitoring and follow-up associated with newer therapies and clinical trials. The study highlights inequities in support for non-CAR-T patients and calls for improved interventions and larger future studies.