Psychosocial care for children receiving chimeric antigen receptor (CAR) T-cell therapy

Abstract

Chimeric antigen receptor (CAR) T-cell therapy has transformed the treatment of relapsed/refractory B-cell acute lymphoblastic leukemia (ALL). However, this new paradigm has introduced unique considerations specific to the patients receiving CAR T-cell therapy, including prognostic uncertainty, symptom management, and psychosocial support. With increasing availability, there is a growing need for evidence-based recommendations that address the specific psychosocial needs of the children who receive CAR T-cell therapy and their families. To guide and standardize the psychosocial care offered for patients receiving CAR T-cell therapy, we propose the following recommendations for addressing psychosocial support.

Keywords: acute lymphoblastic leukemia; chimeric antigen receptor t-cell; communication; interdisciplinary care; palliative care; pediatric oncology; psychosocial; symptom management.

FIGURE 1

Model of Comprehensive Care. Domains of comprehensive psychosocial care, represented by wedges of the circle, include: knowledge and expectations about treatment, mutual understanding of goals of care, assessment of past and present psychosocial needs, and communication with the referring oncology team. Actionable objectives of assessment are included in adjacent boxes.