Day 28 Discharge and Transition to Shared Community Care

Day 28 after ciltacabtagene autoleucel (cilta-cel) infusion marks an important transition for patients with multiple myeloma from center-led care to shared care with the community oncology team. Doris Hansen, MD, and Prerna Mewawalla, MD, discuss strategies for making this transition safe and effective, emphasizing that discharge is not the endpoint of CAR T-cell therapy care. They recommend providing the community team with a concise, 1-page treatment summary that includes the CAR T-cell product, infusion date, any history of cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome, infection risk, prolonged cytopenias, transfusion needs, and the ongoing prophylaxis and vaccination plan. Monthly telehealth visits can help monitor patients for delayed neurotoxicity and prolonged cytopenias, including those who live several hours from the treatment center. The discussion also highlights the importance of a dedicated contact number so patients and community providers can quickly reach the treating center if CAR T-cell-related adverse effects develop after discharge.