• Grace G Bak, Kenneth Micklethwaite, Karen Maddock, and Andrew Coggins.
• Department of General Medicine, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
• Emerg Med Australas. 2023 Dec 1; 35 (6): 103410371034-1037.

ObjectiveChimeric antigen receptor T-cell (CAR-T) therapy is an emerging treatment for refractory hematologic malignancy. Unplanned ED presentations following CAR-T present the increasing need for an integrated model of care that allows for the early recognition of its specific complications.MethodsThis is a prospective observational study at a tertiary centre. CAR-T patients (n = 17) were universally enrolled into a study registry by treating providers. These patients were flagged by investigators to trigger a pop-up notification CAR-T information warning at ED triage. Medical records were reviewed 90 days for unplanned presentations, complications and patient-oriented outcomes.ResultsPatients receiving CAR-T frequently encountered toxicity within 7 days of therapy. This was typically mild and occurred in an inpatient setting. Medical record review revealed five unplanned ED presentations (that were recognised as post CAR-T) and not directly attributable to specific toxicities.ConclusionIf CAR-T therapy is to be used more widely especially in an outpatient model of care, a standardised ED model of care for recognition of specific complications is needed.© 2023 Australasian College for Emergency Medicine.

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