(Research Hub Theater) Inpatient Rehabilitation Outcomes of Cancer Patients After Chimeric Antigen Receptor T-cell Therapy

Background and/or Objectives: While patients receiving chimeric antigen receptor T-cell therapy (CART) frequently experience functional decline that would benefit from inpatient rehabilitation facility (IRF), no currently published studies describe rehabilitation outcomes for this population. Herein, we tested that hypothesis that CART patients have similar functional outcomes to other cancer patients in rehabilitation, when matched for disease and demographic variables.

Design: Retrospective cohort study.

Setting: IRF.

Participants: 76 patients with hematologic malignancies who presented to IRF between January 2017 and December 2021. 11 CART patients were identified and matched by propensity score matching using disease and demographic variables (age, gender, performance status, CNS involvement, and number of prior treatment lines) to 11 patients within the cohort not undergoing CART.

Interventions: not applicable.

Main Outcome Measures: Change in ratios of Section GG and Functional Independence Measure (FIM) scores; hours of therapy; Berg Balance Score (BBS); Six Minute Walk Test (6MWT); Durable Medical Equipment (DME) need; number of blood transfusions; discharge destination; and neutropenia, orthostasis, and infection.

Results: Between the matched populations, change in FIM/Section GG ratios for self-care and transfer were not statistically different (p-value 0.589 and 0.320, respectively). However, change in mobility ratio between these two groups trended towards significance (p-value 0.084), with CART patients with higher median ratio (median=0.318) compared to non-CART patients (median=0.167). Additionally, non-CART patients trended towards discharging to a facility rather than home compared to CART patients (p-value 0.076). Hours of therapy, BBS, 6MWT, DME needs, transfusion needs, and medical complications at IRF were similar between the groups.

Conclusions: When controlling for disease and demographic variables, CART patients had similar, and possibly superior, functional outcomes during rehabilitation compared to matched non-CART patients. While further study of a larger sample size is needed, these data suggest the CART population can achieve functional gains at a similar level to other cancer populations in IRFs.