Car-T and Bispecific Antibodies for Refractory Non-Hodgkin Lymphoma: Long-Term Safety and Autoimmune Sequelae.

Abstract

Background: Refractory non-Hodgkin lymphoma (r/r-NHL) is a clinical problem that has remained challenging even with the significant progress in immunotherapy. The introduction of chimeric antigen receptor T-cell (CAR-T) and bispecific antibody (BsAb) treatment has significantly increased the remission rates, but their safety and autoimmune sequelae are not well-defined in the long run. Professional awareness and attitudes to these new toxicities should be understood to construct safe and sustainable immunotherapeutic systems.

Methods: The cross-sectional quantitative study was carried out in the group of oncologists, hematologists, immunologists, pharmacists, and researchers (n = 263). The questionnaire consisted of 20 items in the Likert scale and was used to collect the data on the efficacy perception, awareness of the toxicity, and long-term immune surveillance. Shapiro-Wilk normal test, Cronbach alpha reliability, KMO and Bartlett validity tests, t-test, ANOVA, Kruskal-Wallis, and Chi-square tests were used as analyses of group differences. Pearson correlation and multiple regression models were used to determine relationships between variables and predictive variables.

Results:  There was no significant deviation of items (p > 0.05), high reliability (α =.931), and sufficient adequacy of the sample of validity (KMO =.824; p =.001). High gender, age, professional, or clinical experience differences were identified (p < 0.05). The correlation analysis indicated that there is an overall strong positive inter-item correlation (r = 0.620.78, p < 0.01). The regression analysis has verified that the strongest predictor is Managed-Patient experience (B = 0.21, p = 0.001) with R 2 = 0.177. In general, the respondents agreed on the curative liability as well as the danger of delayed immune dysregulation as a result of CAR-T and BsAb treatment.

Conclusion: The research paper establishes that healthcare experts are reliable, valid, and perceive the issue of immunotherapy of advanced lymphoma in a well-informed manner. The understanding through experience improves awareness of chronic cytopenia, autoimmune reactions, and infection risks of the results from durable CAR-T or BsAb reactions. The latter findings support the importance of ongoing immunovigilance, multi-disciplinary work, and longitudinal follow-up to achieve sustainable clinical outcomes.