Unraveling the care pathway for CAR T-cell therapy in large B-cell lymphoma: insights from a nationwide study in France (2018-2023).

Abstract

This study describes the inpatient care pathway for 1914 Large B-cell Lymphoma (LBCL) patients treated with CAR T-cell therapy in France between 2018 and 2023 and identifies factors influencing their management. Based on a retrospective analysis of the French national hospital database, we found the average CAR T-cell infusion stay was shorter for patients in the second line of treatment <i>versus</i> later lines (20.4 <i>vs.</i> 23.8 days). The specific product used was also influential; for example, lisocabtagene maraleucel was associated with shorter stays and fewer ICU admissions than axicabtagene ciloleucel. A multivariate analysis confirmed that while patient characteristics and the CAR T-cell product influenced outcomes, higher center experience was a primary determinant. More experienced centers had shorter hospital stays and a higher probability of patients being discharged home, demonstrating that the management of CAR T-cell patients is largely dependent on institutional experience.