CAR T-cell therapy takes heaviest toll on patients around discharge, study finds

Patients receiving CAR T-cell therapy report their greatest physical and functional burden during post-infusion hospitalization and around discharge, with measurable recovery by seven to eight weeks after leaving hospital, according to a prospective single-center observational study conducted at a German tertiary hospital and published in BMC Cancer.

The study enrolled adults scheduled for CAR T-cell therapy. Of 52 patients in the screening and recruitment log, 32 who completed at least three of four assessments formed the longitudinal cohort. The participants included 17 male and 15 female patients, with a median age of 61.0 years (interquartile range 53.0 to 65.5), and 23 of 32 participants, or 71.9 percent, had multiple myeloma.

Assessments took place at four timepoints: before treatment (T0), during post-infusion hospitalization (T1), at or around discharge (T2), and seven to eight weeks after discharge (T3). Standardized instruments measured quality of life, anxiety and depression, loneliness, fear of progression, somatic symptoms, and social support. Unadjusted generalized estimating equations were used to examine longitudinal change, while supportive care items were summarized descriptively and open-ended responses were analyzed thematically.

Global health status and quality of life showed an overall time effect (p = 0.001), with the lowest mean observed at T2, the discharge timepoint, and recovery by T3. Physical functioning was nominally lower at T2 (β = -14.450, p = 0.046). Fatigue was nominally higher at both T1 and T2 (β = 11.990, p = 0.015 and β = 15.574, p = 0.008 respectively), and the QLQ-C30 summary score was lower at T1 and T2 (β = -7.772, p = 0.006 and β = -6.954, p = 0.035).

Loneliness was nominally higher at T1, during hospitalization (β = 0.795, p = 0.009). In contrast, PHQ-4 scores, a brief measure of anxiety and depression, changed little across the treatment course. The authors note that these brief anxiety and depression scores captured only part of participants’ support needs, suggesting that standard screening instruments may miss dimensions of distress that patients experience during this intensive therapy.

Supportive care preferences remained consistently high across all timepoints. Between 60.0 and 70.0 percent of participants considered post-discharge psycho-oncological support useful, and between 66.7 and 79.3 percent considered peer contact useful. These figures held steady from before treatment through the weeks after discharge, indicating sustained demand for structured support throughout the treatment journey.

Thematic analysis of open-ended responses identified five themes concerning patients’ own accounts: treatment uncertainty, physical decline, multidimensional support needs, accessible and individualized digital support, and incomplete treatment understanding. The presence of digital support as a distinct theme aligns with the study’s focus on digital supportive care preferences, which the researchers examined alongside patient-reported outcomes rather than in isolation.

The study’s background notes that prospective studies of CAR T-cell therapy have described changes in patient-reported outcomes, but these are rarely examined together with supportive care preferences and patients’ own accounts. By combining standardized measures with thematic analysis across four timepoints, the study offers a more integrated picture of the patient experience during a treatment course that spans pre-treatment preparation, hospitalization, discharge, and early recovery.

The authors conclude that patient-reported physical and functional burden was greatest during hospitalization and around discharge and improved by seven to eight weeks after discharge. They state that the findings can inform the co-design and prospective evaluation of longitudinal supportive care approaches, while explicitly cautioning that the study does not establish the effectiveness of any intervention. As a prospective single-center observational study with a cohort of 32 participants, the results describe patterns in one setting rather than testing a treatment, and the researchers frame the work as a foundation for future evaluation rather than a demonstration of benefit.

Subject of Research: Psychosocial burden, quality of life, and digital supportive care preferences among adults undergoing CAR T-cell therapy

Article Title: Longitudinal psychosocial burden, quality of life, and digital supportive care preferences before and after CAR T-cell therapy: a prospective single-center observational study

Article References: Fleischer, A., Bergert, S.-A., Strunz, P.-P., Huber, B., Schassberger, N., Benz, M., Jentschke, E., Eisele, F., Tamamushi, Y., Einsele, H., Rasche, L., Hudecek, M., Duell, J., Topp, M., & Maatouk, I. (2026). Longitudinal psychosocial burden, quality of life, and digital supportive care preferences before and after CAR T-cell therapy: a prospective single-center observational study. BMC Cancer. https://doi.org/10.1186/s12885-026-17245-y

Image Credits: AI Generated

DOI: 10.1186/s12885-026-17245-y

Keywords: CAR T-cell therapy, quality of life, psychosocial burden, patient-reported outcomes, supportive care, loneliness, fatigue, anxiety, depression, digital health, multiple myeloma, psycho-oncology