Long-Term Follow-Up and Late Effects

Little is known about the long-term effects of CAR-T cell therapy. Although medium-term complications, such as cytopenia and hypogammaglobulinaemia, may persist and require ongoing treatment, there do not appear to be other durable toxicities specific to this new immunotherapeutic class (Fried et al. 2019; Cordeiro et al. 2020; Cappell et al. 2020). However, to date, CAR-T therapy has been evaluated in patients with multiple relapsed diseases following several lines of treatment, including allogeneic stem cell transplantation, making it difficult to identify which effects may be directly attributable to this novel treatment. Nonetheless, as the use of CAR-T cell therapy increases, structured models for survivorship care will need to be established. The factors that will affect care requirements include the primary malignancy, prior treatment, the specific CAR-T therapy and patient age and frailty.