Why Is a Care Partner Essential to the CAR T-Cell Therapy Process?

Katherine Banwell:

Why are care partners essential members of the healthcare team?

Dr. Krina Patel:

Yeah, and I think this is the entire journey of multiple myeloma. When our patients are going through treatments, there are going to be days that are great.

There are going to be times when there might be complications, infections, and really, with CAR T therapy, because there are nuances and potential complications, at least in the first couple of weeks, patients, their care partners are so, so vital to the process that if someone doesn’t have a care partner, at least for the first couple of weeks, we actually won’t do the CAR T therapy, because it’s really important that in case somebody has any side effects, that there’s somebody there to bring them in and kind of keep an eye on things.

And again, I think with CAR T therapy, we’re evolving. It used to be four weeks and eight weeks that patients would need a care partner, and we’ve learned so much that we know our patients don’t really get the neurotoxicity that we were worried about before, but there are certain patients that, especially in the first couple of weeks after CAR T, that that can happen. And so, again, our care partners are the folks that actually can take care of these patients the best and call us when they need us.

Katherine Banwell:

What is the role of the care partner, of someone who’s undergoing CAR T-cell therapy?

Dr. Krina Patel:

Yeah, so, I think this is the person who can speak for the patient if something is going wrong, so again – or if they are just somebody who doesn’t like to tell us things. And so, a lot of my patients will tell me if they’re not feeling well. Others will sort of say, “Eh, it’s probably just expected, so maybe it’s just I’m getting older,” and usually care partners are the folks that really recognize if something is different, day to day.

And again, they are the folks that can communicate to us to say, “Listen, this is something that’s going wrong,” or, “Hey, they’re just a little different.” And that, again, with CAR T therapy, the outcomes have improved so much, but part of the outcomes improving is because we can intervene a lot faster now before waiting until things get really bad.

And so, again, it’s not just serious things where someone could all of a sudden have a fever and they’re not making sense and they’re delirious and they wouldn’t be able to call an ambulance to get to the hospital, but it really is even the little things.

Sometimes we’ll see people with low-grade fevers that maybe they just called someone the wrong name by accident that most of us would say, “Okay, it’s fine,” but that care partner knows that patient much better and would say, “No, that doesn’t seem right,” and I can intervene faster to make sure they don’t have the bigger delirium and those types of things.

So, again, it’s the entire time, from the chemo and apheresis all the way to the cells and the two to four weeks after, and even after that, it’s not – the journey doesn’t end after our patients are done with their CAR T therapy. It really is the survivorship part of CAR T afterwards, and again, having that extra voice is so, so important.