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Review
. 2022 Jun;24(6):741-749.
doi: 10.1007/s11912-022-01240-0. Epub 2022 Mar 10.

Rehabilitation Needs for Patients Undergoing CAR T-Cell Therapy

Obada Obaisi  1 , Rhodora C Fontillas  2 , Krina Patel  3 , An Ngo-Huang  4
Affiliations
Review

Rehabilitation Needs for Patients Undergoing CAR T-Cell Therapy

Obada Obaisi et al. Curr Oncol Rep. 2022 Jun.

Abstract

Purpose of review: Chimeric antigen receptor (CAR) T-cell therapy is a relatively new, innovative treatment strategy to manage refractory hematological cancers, including some types of leukemia, lymphoma, and multiple myeloma. This article outlines the CAR T-cell therapy process, toxicity, and complications, along with an overview of the currently known short- and long-term physical and functional sequelae that will be helpful for general or oncology rehabilitation specialists caring for these patients.

Recent findings: There is a dearth of literature on the topic of rehabilitation of patients receiving CAR T-cell therapy. Rehabilitation practices can be extrapolated from the limited functional information on patients who have completed treatment for lymphoma and multiple myeloma. Patients present with cognitive impairment, muscle weakness, reduced exercise capacity, neuropathy, and cancer-related fatigue. Physical activity and rehabilitation programs may be beneficial to address fatigue, psychological symptoms, and quality of life. There is limited rehabilitation research in patients receiving CAR T-cell therapy. These patients may present with general deconditioning and neurological complications which translate to neuromuscular and cognitive impairment that benefit from multidisciplinary rehabilitation intervention prior to, during, and after treatment. Studies measuring the impairments at baseline and evaluation of the impact of rehabilitation practices are much needed to support this.

Keywords: CAR T-cell; CAR T-cell rehabilitation; Cancer rehabilitation; Exercise oncology; Lymphoma rehabilitation; Multiple myeloma rehabilitation.

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Conflict of interest statement

Dr. Obada Obaisi, Dr. Rhodora Fontillas, and Dr. An Ngo-Huang declare they have no financial interests. Dr. Krina Patel served on the advisory boards and received research funding from Janssen, Bristol Meyers Squibb; served on the advisory board for Arcellx and Pfizer; and completed clinical trials with Cellectis, Poseida, Takeda, and Prescisionbio.

Figures

Fig. 1
Fig. 1
Elements of the Enhanced Recovery Cellular Transplant (ER-CT) program, a multidisciplinary supportive care approach. Abbreviations: MD/DO, medical doctor/doctor of osteopathic medicine; APP, advanced practice provider; PM&R, Physical Medicine and Rehabilitation physicians; PT, physical therapists; OT, occupational therapists; RN, registered nurse
See this image and copyright information in PMC

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