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Mediport use as an acceptable standard for CAR T cell infusion.
- Eylon, Maya;
- Prabhu, Snehit;
- John, Samuel;
- King, Maxwell;
- Bhatt, Dhruv;
- Curran, Kevin;
- Erickson, Courtney;
- Karras, Nicole;
- Phillips, Christine;
- Satwani, Prakash;
- Southworth, Erica;
- Baumeister, Susanne;
- Talano, Julie-An;
- MacMillan, Margaret;
- Rossoff, Jenna;
- Bonifant, Challice;
- Myers, Gary;
- Rouce, Rayne;
- Toner, Keri;
- Driscoll, Timothy;
- Katsanis, Emmanuel;
- Salzberg, Dana;
- Capitini, Christian;
- Pacenta, Holly;
- Pfeiffer, Thomas;
- Shah, Niketa;
- Huynh, Van;
- Skiles, Jodi;
- Fraint, Ellen;
- McNerney, Kevin;
- Quigg, Troy;
- Krueger, Joerg;
- Ligon, John;
- Fabrizio, Vanessa;
- Baggott, Christina;
- Laetsch, Theodore;
- Schultz, Liora;
- Hermiston, Michelle;
- De Oliveira, Satiro;
- Schiff, Deborah
- et al.
Abstract
INTRODUCTION: Mediport use as a clinical option for the administration of chimeric antigen receptor T cell (CAR T cell) therapy in patients with B-cell malignancies has yet to be standardized. Concern for mediport dislodgement, cell infiltration, and ineffective therapy delivery to systemic circulation has resulted in variable practice with intravenous administration of CAR T cell therapy. With CAR T cell commercialization, it is important to establish practice standards for CAR T cell delivery. We conducted a study to establish usage patterns of mediports in the clinical setting and provide a standard of care recommendation for mediport use as an acceptable form of access for CAR T cell infusions. METHODS: In this retrospective cohort study, data on mediport use and infiltration rate was collected from a survey across 34 medical centers in the Pediatric Real-World CAR Consortium, capturing 504 CAR T cell infusion routes across 489 patients. Data represents the largest, and to our knowledge sole, report on clinical CAR T cell infusion practice patterns since FDA approval and CAR T cell commercialization in 2017. RESULTS: Across 34 sites, all reported tunneled central venous catheters, including Broviac® and Hickman® catheters, as accepted standard venous options for CAR T cell infusion. Use of mediports as a standard clinical practice was reported in 29 of 34 sites (85%). Of 489 evaluable patients with reported route of CAR T cell infusion, 184 patients were infused using mediports, with no reported incidences of CAR T cell infiltration. DISCUSSION/CONCLUSION: Based on current clinical practice, mediports are a commonly utilized form of access for CAR T cell therapy administration. These findings support the safe practice of mediport usage as an accepted standard line option for CAR T cell infusion.
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