Recommended monitoring of late complications in adult patients receiving CAR T-cell therapy
| Frequency of visits* |
| • Monthly for the first 12 months after CAR T-cell infusion • Every 3 months in months 13-24 after CAR T-cell infusion • Every 6 months >24 months after CAR T-cell infusion |
| Laboratory testing |
| • CBC, CMP, LDH at every visit • CRP, ferritin, fibrinogen every visit for the first 12 months after CAR T-cell infusion • Quantitative immunoglobulins monthly until IgG >400 mg/dL, then every 3 months in the first 24 months after CAR T-cell infusion • CMV, EBV, and HBV in patients known to be seropositive every 3 months in the first 24 months after CAR T-cell infusion. Frequency increases to every 1 to 4 weeks in patients found to have detectable viral levels |
| Bone marrow examination |
| • As clinically indicated for suspicion of recurrent disease and for evaluation of cytopenias |
| Radiology |
| • As clinically indicated for suspicion of recurrent disease and for evaluation of infections |
| Frequency of visits* |
| • Monthly for the first 12 months after CAR T-cell infusion • Every 3 months in months 13-24 after CAR T-cell infusion • Every 6 months >24 months after CAR T-cell infusion |
| Laboratory testing |
| • CBC, CMP, LDH at every visit • CRP, ferritin, fibrinogen every visit for the first 12 months after CAR T-cell infusion • Quantitative immunoglobulins monthly until IgG >400 mg/dL, then every 3 months in the first 24 months after CAR T-cell infusion • CMV, EBV, and HBV in patients known to be seropositive every 3 months in the first 24 months after CAR T-cell infusion. Frequency increases to every 1 to 4 weeks in patients found to have detectable viral levels |
| Bone marrow examination |
| • As clinically indicated for suspicion of recurrent disease and for evaluation of cytopenias |
| Radiology |
| • As clinically indicated for suspicion of recurrent disease and for evaluation of infections |
Visits may be performed at either the cell therapy center (CTC) or the patient's referring hematologist oncologist; recommended that patient be seen at least semiannually in first 24 months.
CBC, complete blood count; CMP, comprehensive metabolic panel (including electrolytes, creatinine, total bilirubin, AST (aspartate transaminase), and ALT (alanine transaminase)); CRP, C-reactive protein; CMV, cytomegalovirus; EBV = Epstein-Barr virus; HBV = hepatitis B virus; IgG = immunoglobulin G; LDH, lactate dehydrogenase.