CAR-T细胞疗法已经改变了难治性血液恶性肿瘤的治疗方法，但具有复杂的后勤工作和独特的毒副作用。研究CAR-T接受者患者报告的结果（PROs）的数据有限。我们在一所学术中心进行了一个长期的研究，调查了接受CAR-T治疗的血液恶性肿瘤成年患者的生活质量（QOL）（癌症治疗功能评估-常规），心理压力（医院焦虑和抑郁量表，患者健康问卷-9，创伤后应激障碍[PTSD]清单）和身体症状（埃德蒙顿症状评估量表-修订版）。我们在CAR-T输注前、1周、1个月、3个月和6个月评估了这些因素。我们采用线性混合模型确定与QOL轨迹相关的因素。我们招募了符合资格的患者中的72.5％（103/142）（3人未接受CAR-T）。 QOL（B=1.96，p <0.001）和抑郁症状（B= -0.32，p = 0.001）在CAR-T后1周恶化，然后在6个月恢复。在6个月时，18％，22％和22％的患者报告存在临床意义的抑郁、焦虑和PTSD症状。在1周时，52％的患者注意到严重物理症状，CAR-T后6个月下降到28％。在未经调整的线性混合模型中，ECOG表现状态较差（B =1.24，p = 0.042）、接受托珠单抗（B =1.54，p = 0.042）和接受用于CRS和/或ICANS的皮质类固醇（B =2.05，p = 0.006）与更高的QOL轨迹相关联。接受CAR-T后，QOL下降，抑郁症状早期加重，然后在输注6个月后QOL、心理压力和身体症状有所改善。一小部分患者纵向报告存在严重的心理压力和身体症状，强调了对支持性护理干预的需求。版权所有© 2023年美国血液学会。

CAR-T cell therapy has transformed treatment for relapsed/refractory hematologic malignancies but has complex logistics and unique toxicities. Data examining the patient-reported outcomes (PROs) of CAR-T recipients are limited. We conducted a longitudinal study of adults with hematologic malignancies receiving CAR-T at a single academic center. We assessed quality of life (QOL) (Functional Assessment of Cancer Therapy-General), psychological distress (Hospital Anxiety and Depression Scale, Patient Health Questionnaire-9, post-traumatic stress disorder [PTSD] checklist) and physical symptoms (Edmonton Symptom Assessment Scale-revised) at baseline, 1 week, 1 month, 3 months, and 6 months post CAR-T infusion. We utilized linear mixed models to identify factors associated with QOL trajectory. We enrolled 72.5% (103/142) of eligible patients (3 did not receive CAR-T). QOL (B=1.96, p<0.001) and depression symptoms (B=-0.32, p=0.001) worsened by 1 week then improved by 6 months post CAR-T. At 6 months, 18%, 22%, and 22% of patients reported clinically significant depression, anxiety, and PTSD symptoms, respectively. At 1 week, 52% noted severe physical symptoms, declining to 28% at 6 months post CAR-T. In unadjusted linear mixed models, worse ECOG performance status (B=1.24, p=0.042) receipt of tocilizumab (B=1.54, p=0.042) and receipt of corticosteroids for CRS and/or ICANS (B=2.05, p=0.006) were associated with higher QOL trajectory. After CAR-T, QOL declined and depression symptoms increased early followed by improvement in QOL, psychological distress, and physical symptoms by 6 months post infusion. A significant minority of patients report substantial psychological distress and physical symptoms longitudinally, underscoring the need for supportive care interventions.Copyright © 2023 American Society of Hematology.