This Post-Activity Assessment includes 3 case studies each with 3 questions.
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SA is a 21 year old female with acute lymphoblastic leukemia (ALL). She was diagnosed when she was 19 and started on CALGB 10403. During course 3 she progressed and is now starting re-induction with inotuzumab. SA is not interested in pursuing a stem cell transplant after this therapy if she achieves CR and prefers to consider other options for therapy. CAR T-cell therapy is discussed with the patient and she is agreeable.
Which therapy option is preferred for SA?
When explaining the risks versus benefits of CAR T-cells for ALL, which of the following statements would be correct?
SA is very concerned about the risk of CRS. Which of the following statements about CRS is true?
YM is a 19 year old male with ALL about to receive CAR T-cells. He resides with his parents and they are helping him through his treatment.
You are asked to counsel the patient about receiving CAR T-cell therapy. What counseling point is the most important to communicate with the patient and caregiver?
Approximately 3 days after receiving his CAR T-cells, YM is admitted to the hospital with a fever of 103.6 F. He subsequently has a blood pressure of 90/66 and is given a bolus of IV fluids. His repeat BP is 98/68. The best option to treat cytokine release syndrome (CRS) associated with tisagenleuleucel is:
What risk factor(s) does YM have for development of CRS?
LH is a 67 year old male with DLBCL. Upon initial diagnosis, he was noted to have c-MYC and BCL-2 rearrangements. He was initially treated with dose-adjusted R-EPOCH (DA-R-EPOCH), however, then relapsed 6 months later. He was then treated with ICE followed by an autologous stem cell transplant. LH now presents to his hematologist with complaints of fatigue and lymphadenopathy and is determined to have relapsed disease.
Which therapy would you consider next for LH?
When deciding to proceed with CAR T-cells LH asks if he needs to be treated before receiving the CAR T-cells. Which would be the best option for bridge therapy until the CAR T-cells are ready for infusion?
Three years after receiving CAR T-cell therapy LH develops B cell aplasia? Which of the following statements is correct?