Increasing use of CAR-T therapy occurs in conjunction with decreasing stem cell transplants with stable resource usage over a 6-year period: Resource utilization implications.

Abstract

Background: Since FDA approval in 2017, CAR-T therapy has seen rapid clinical adoption. Shifting clinical trends have emerged with increasing utilization of CAR-T therapies and a downward trend in HSCTs. Given the overlapping resources required for the manufacture and storage of these products, we sought to examine trends over a 6-year period.

Methods: The apheresis patient database and Lab database were reviewed to compile a list of patients that underwent either CAR-T or HSCT (autologous) collections, and/or received CAR-T or autologous HSCT infusions between January 1, 2018 and December 12, 2023. This was further examined by year and disease group.

Results: The total number of patients collecting for CAR-T increased from 52 in 2018 to 150 in 2023 (slope = 21.97; p = .0013), accompanied by a decrease in the number of patients collecting for HSCT, from 425 in 2018 to 341 in 2023 (slope = -21.2; p = .0177). Neither total number (calculated as number of HSCT + CAR-T) of patients collected (mean 476 + 20.4 per year), nor collection procedures (mean 972 ± 75.8 per year) changed significantly over the 6-year period. The total number of CAR-T infusions increased from 24 in 2018 to 111 in 2023 (slope = 17.7; p = .004), with a decrease in auto-HSCT from 400 to 289 (slope = -28.7; p = .008). The overall number of infusions (calculated as number of HSCT + CAR-T) did not change significantly (slope = -10.9; p = .13) over the 6-year period.

Discussion: Our findings confirm the increasing adoption of CAR-T therapy occurring alongside a decreasing stem-cell transplants, with stable overall resource utilization.