France: Building capacity beyond CAR T-cell therapy treatment centers

Health system capacity is an important factor in the delivery of CAR T-cell therapy. For example, treatment centers need enough intensive care beds to manage potential treatment-related adverse events and apheresis units must be able to keep up with demand for CAR T-cell therapy to prevent any delays in treatment.⁶ 

As indications for CAR T-cell therapy are expected to expand, it is important to carefully plan capacity to manage the pressures on healthcare systems and ensure eligible patients can access treatment. In France, several CAR T-cell treatment centers have found and built on capacity elsewhere in the system.⁶ For example:

• Collaboration with the French Blood Collection Association (EFS) has developed apheresis capacity beyond the CAR T-cell treatment centers.⁶
• Specialized rehabilitation centers offer patient monitoring and accommodation following CAR T-cell infusion, which has helped release hospital beds at treatment centers in Montpellier and Lyon.⁶ 
• The Centre Hospitalier Universitaire de Montpellier has lowered their average patient hospital stay by 3 days by shifting lymphodepletion (temporarily depleting a person’s T-cell numbers before CAR T-cell therapy) to an outpatient setting.⁶ Similarly, Toulouse University Hospital and West Onco-Occitanie cancer network have outsourced lymphodepleting chemotherapy to their referring centers (n=163). This approach reduced hospital stays from a median of 20 to 14 days.¹¹⁹