For patients receiving outpatient CAR T-cell therapy, all aspects of care – including preparative chemotherapy, CAR T infusion, and follow-up monitoring – take place in our outpatient clinic. Rather than staying in the hospital, patients return home or to a nearby hotel each day.
Outpatient CAR T-cell therapy is just as safe and effective as inpatient treatment, and the care patients receive is the same for both settings.
Hear from our dedicated team of clinicians as well as patients sharing their own experiences on receiving CAR T-cell therapy in the outpatient setting.
Patient Referrals and Consults 617-632-6028 dana-farber.org/refer . We look forward to working together to care for our shared patients.
CAR T-cell Therapy
CAR T cell therapy is a treatment where we take a patient's T cells, uh, collect them, and then genetically modify them to recognize cancer cells. We then infuse this back into the patient. Historically we were giving these therapies in the hospital, but what we've learned over the last few years is that outpatient therapy is very safe and effective. We are able to give the patient a safe, comfortable experience in the outpatient setting. While still allowing them to get that expert level of care on the inpatient side if they need, we want the patients to have the improved quality of life of outpatient care and being able to go back to the hotel, sleeping somewhere that's more comfortable, less interruptions overnight, and more ability to go out into the world. After talking with the doctor and my husband, we really felt like it would be better to be in a hotel. Setting instead of the hospital because I could get up and move around. I wouldn't have to be in the bed all the time. We were very fortunate to be nearby. We had friends who had an apartment within 2 miles of the hospital, so we stayed there. I did speak with a resource specialist at Dana-Farburn. She helped with the hotel and with the parking. I had to check in daily with the hospital. In the morning I would go to the hospital and they would do the vitals. When patients are coming for their outpatient care, the first day that they're getting their clearance visit is a lengthy day that can be anywhere between 4 to 8 hours depending on how quickly they can get their central line. When they're coming for their chemo days, it can be anywhere between 4 and 6 hours. The role of the caregiver in outpatient C T cell therapy is really pivotal. That patient's caregiver is really helping manage all of their care and being that liaison between the patient and the care team if the patient's unable to do that themselves. It's 24 hours a day, 7 days a week for a defined period of time. I had a lot of hesitation before, a lot. I'm telling you, I didn't show it, but I was very worried. What do I do outpatient if something goes wrong? But when they give me the numbers and the book that I check the blood, I check everything, that gives me a lot of confidence. My husband learned how to do the blood pressure machine and. All the vitals that he had to take several times a day. I knew I got to get a temperature, her oxygen, her heartbeat, blood pressure, and also I need to ask her how is her brain functioning. Is she hallucinated or is she completely aware? Doing all of those neurologic checks helps us get a very good baseline. So if there was a transition of care into the inpatient setting, we know what that patient's baseline is. And when they start to show signs of any of the side effects that we can expect. From CAR T cells we then make a decision whether the patient needs to come into the hospital. So that has really been quite effective because now patients only go into the hospital for the duration that they need to be hospitalized for, being able to have the hospital nearby, having a whole listing of people with whom you could call and to know their pager numbers, it was very comforting. I don't think there could have been anything else done in a hospital that wasn't cared for at the hotel and outpatient situation. Every day I, I walk with her. I take it outside and we went around the block and always I carry water with me. Water was the major thing. The first day, maybe I walked for a half a block. By the time the 6 or 8 days were finished, I was walking around the reservoir. Being able to see the positive outcomes from the outpatient care delivery model has been really rewarding for us as clinicians. I was happy doing the outpatient situation because it gave me more flexibility. I really relished having freedom. It gave me peace of mind to know that I was near the hospital, but that I could go home to a quiet, comfortable environment. It was really very beneficial for my recovery.
