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Examining the Longer-Term Effects of Car T-Cell Therapy on Adult Patients and Their Caregivers
Examining the Longer-Term Effects of Car T-Cell Therapy on Adult Patients and Their Caregivers
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20250211152140
- ISBN
- 9798384023142
- DDC
- 610.73
- 저자명
- Andersen, Lucy.
- 서명/저자
- Examining the Longer-Term Effects of Car T-Cell Therapy on Adult Patients and Their Caregivers
- 발행사항
- [Sl] : University of Pennsylvania, 2024
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2024
- 형태사항
- 134 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 86-02, Section: B.
- 주기사항
- Advisor: Deng, Jie.
- 학위논문주기
- Thesis (Ph.D.)--University of Pennsylvania, 2024.
- 초록/해제
- 요약Chimeric Antigen Receptor (CAR) T-cell therapy is an immunotherapy treatment for hematologic malignancies, including B-cell lymphoma and multiple myeloma. A majority of patients experience Cytokine Release Syndrome (CRS) and Immune Effector Cell-Associated Neurotoxicity (ICANS) within the first few weeks after CAR T-cell therapy. However, the long-term effects of CRS and ICANS are under-researched, with limited studies showing an association between acute CRS and ICANS and worsening symptom burden and cognitive function. Additionally, the impact of CAR T-cell therapy on caregivers and on finances is under-explored, notwithstanding assessing patient and caregiver outcomes in the context of social determinants of health (SDoH). This dissertation examines the longer-term impacts of CAR T-cell therapy using the SDoH framework. Article 1 qualitatively described the symptom experience among patients in remission three months to one-year after CAR T-cell therapy. Articles 2 and 3 used data from a cross-sectional study of patients in remission one to five years after CAR T-cell therapy and their caregivers. Article 2 used bivariate analyses to identify clinical and SDoH factors associated with longer-term outcomes (health related quality of life [HRQoL], cognitive function, and symptom burden) and linear regression analyses to identify the impact of acute CRS or ICANS on longerterm cognitive function and symptom burden. Article 3 utilized linear regression to examine if caregiving burden is impacted by patient HRQoL, cognitive function, and symptom burden and exploratory bivariate analyses to identify factors associated with financial toxicity. Patients three months to one-year after CAR T-cell therapy reported common symptoms of fatigue, neuropathy, insomnia, and memory issues, which were managed independently without severe impact to daily life (Article 1). Among patients in longer-term remission after CAR T-cell therapy, lower income and comorbidities were associated with worse HRQoL. Acute CRS and ICANS toxicity did not predict longer-term symptom burden nor cognitive function (Article 2). Caregivers reported low caregiving burden, though younger age was associated with higher burden and patient financial toxicity was higher than caregiver financial toxicity (Article 3). Findings advance the understanding of patient and caregiver long-term health after CAR T-cell therapy and inform future supportive care interventions for this rapidly expanding population.
- 일반주제명
- Nursing
- 일반주제명
- Oncology
- 일반주제명
- Immunology
- 키워드
- Quality of life
- 키워드
- Symptom burden
- 기타저자
- University of Pennsylvania Nursing
- 기본자료저록
- Dissertations Abstracts International. 86-02B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■020 ▼a9798384023142
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■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a610.73
■1001 ▼aAndersen, Lucy.
■24510▼aExamining the Longer-Term Effects of Car T-Cell Therapy on Adult Patients and Their Caregivers
■260 ▼a[Sl]▼bUniversity of Pennsylvania▼c2024
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2024
■300 ▼a134 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 86-02, Section: B.
■500 ▼aAdvisor: Deng, Jie.
■5021 ▼aThesis (Ph.D.)--University of Pennsylvania, 2024.
■520 ▼aChimeric Antigen Receptor (CAR) T-cell therapy is an immunotherapy treatment for hematologic malignancies, including B-cell lymphoma and multiple myeloma. A majority of patients experience Cytokine Release Syndrome (CRS) and Immune Effector Cell-Associated Neurotoxicity (ICANS) within the first few weeks after CAR T-cell therapy. However, the long-term effects of CRS and ICANS are under-researched, with limited studies showing an association between acute CRS and ICANS and worsening symptom burden and cognitive function. Additionally, the impact of CAR T-cell therapy on caregivers and on finances is under-explored, notwithstanding assessing patient and caregiver outcomes in the context of social determinants of health (SDoH). This dissertation examines the longer-term impacts of CAR T-cell therapy using the SDoH framework. Article 1 qualitatively described the symptom experience among patients in remission three months to one-year after CAR T-cell therapy. Articles 2 and 3 used data from a cross-sectional study of patients in remission one to five years after CAR T-cell therapy and their caregivers. Article 2 used bivariate analyses to identify clinical and SDoH factors associated with longer-term outcomes (health related quality of life [HRQoL], cognitive function, and symptom burden) and linear regression analyses to identify the impact of acute CRS or ICANS on longerterm cognitive function and symptom burden. Article 3 utilized linear regression to examine if caregiving burden is impacted by patient HRQoL, cognitive function, and symptom burden and exploratory bivariate analyses to identify factors associated with financial toxicity. Patients three months to one-year after CAR T-cell therapy reported common symptoms of fatigue, neuropathy, insomnia, and memory issues, which were managed independently without severe impact to daily life (Article 1). Among patients in longer-term remission after CAR T-cell therapy, lower income and comorbidities were associated with worse HRQoL. Acute CRS and ICANS toxicity did not predict longer-term symptom burden nor cognitive function (Article 2). Caregivers reported low caregiving burden, though younger age was associated with higher burden and patient financial toxicity was higher than caregiver financial toxicity (Article 3). Findings advance the understanding of patient and caregiver long-term health after CAR T-cell therapy and inform future supportive care interventions for this rapidly expanding population.
■590 ▼aSchool code: 0175.
■650 4▼aNursing
■650 4▼aOncology
■650 4▼aImmunology
■653 ▼aChimeric Antigen Receptor
■653 ▼aFinancial toxicity
■653 ▼aCytokine Release Syndrome
■653 ▼aPatient-reported outcomes
■653 ▼aQuality of life
■653 ▼aSymptom burden
■690 ▼a0569
■690 ▼a0992
■690 ▼a0982
■690 ▼a0769
■71020▼aUniversity of Pennsylvania▼bNursing.
■7730 ▼tDissertations Abstracts International▼g86-02B.
■790 ▼a0175
■791 ▼aPh.D.
■792 ▼a2024
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17163142▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
