Comparison of Outpatient and Inpatient Axi-Cel for the Treatment of DLBCL
Battiwalla M, Egloff SA, Nadimpalli G, et al. Outpatient Versus Inpatient Axicabtagene Ciloleucel CAR T-Cell Therapy in Non-Hodgkin's Lymphoma: Insights from a US Multicenter Transplant and Cellular Therapy Network. Transplantation and Cellular Therapy. 2026; (doi: 10.1016/j.jtct.2026.02.057).
Researchers report that outpatient (OP) administration of axicabtagene ciloleucel (axi-cel) is a viable alternative to inpatient (IP) delivery of the chimeric antigen receptor (CAR) T-cell therapy in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Providers favor IP treatment because of the potential for toxicities, but the retrospective study found that rates of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were similar regardless of infusion setting. The investigation included 96 patients with DLBCL who received axi-cel as inpatients and 47 as outpatients. CRS developed in 83% of outpatient recipients and 85% of inpatient recipients, while ICANS occurred in 34% of outpatients and 56% of inpatients. OP administration was associated with less hospitalization: 13% of patients in the OP arm avoided any post-infusion admission. Individuals requiring in-hospital care after infusion stayed for a median of 7 days compared with 15 days for patients who received IP axi-cel. OP administration was also non-inferior to IP administration in terms of progression-free survival. Study authors say the feasibility of OP delivery hinges on remote patient monitoring, structured care pathways, and other supportive elements.