Retired nurse Myra Almon had experienced anemia for years, so in 2017 while living in Florida, her physician recommended testing to determine the root of the issue. Myra was ultimately diagnosed with multiple myeloma, a form of cancer that affects the plasma cells in the bone marrow. She underwent an outpatient stem cell transplant to treat it, which was successful.
In 2020, Myra and her husband, Tony, moved to western North Carolina, as Myra is originally from the state. She continued follow-up care with a local oncologist.
“My myeloma ‘behaved’ while I took my medication every three out of four weeks,” she says. “And then, as so often happens, it decided to raise its ugly head.”
Myra’s oncologist referred her to Dr. Barry Paul, a hematologist at Atrium Health Levine Cancer.
Myra’s new multiple myeloma treatment plan
“Myra has relapsed multiple myeloma, which had previously been treated with three lines of therapy, including a stem cell transplant,” says Dr. Paul. “She had six years of benefit from her stem cell transplant and maintenance therapy, so when her disease relapsed, we needed to consider a new therapy.”
Myra previously had significant toxicity from one of the mainstays of myeloma treatment, which limited her treatment options moving forward. Thankfully, CAR T-cell therapy was recently approved for patients like Myra, which offered her an excellent treatment option, says Paul. CAR T-cell therapy is a type of immunotherapy where a patient's own T-cells, or white blood cells, are collected and genetically modified to better recognize and attack cancer cells, and then reintroduced into the patient's body to target and destroy the disease.
Levine Cancer had just begun offering cellular therapy, like CAR-T, on an outpatient basis. Myra was a good candidate for this option as she is a retired nurse with extensive healthcare knowledge and has caregiving support from her husband.
The benefits of outpatient cellular therapy for multiple myeloma
The outpatient option allows patients to receive the same level of care offered to patients who undergo inpatient treatment without an extended stay in a hospital. Patients undergoing inpatient cellular therapy often need to spend two to three weeks in the hospital, which can be emotionally challenging.
“Allowing patients to stay at home or in an apartment close to our center helps to prevent certain complications and is associated with better emotional health and patient satisfaction,” says Paul. “At the same time, we can still monitor them closely and support them as needed. Patients can sleep uninterrupted by the noises of the hospital, have more food choices than what is available on the hospital menu, which often promotes better intake, and can spend time outdoors. All these benefits contribute to improved emotional health and aid physical recovery. It truly is a win-win for patients.”
Myra’s experience with outpatient cellular therapy
“Considering my options for treatment was necessary. While it’s great to have options, it can be daunting to look at the literature,” says Myra. “Given the success rate of CAR T-cell therapy, we jumped on the opportunity to proceed as an outpatient. I have such faith in my husband’s ability to pick up on subtle changes that could indicate any issues.”
Following her treatment, Myra and her husband stayed in Charlotte to monitor for the expected side effects of CAR-T. Eventually, Myra was admitted to the hospital as planned to manage those side effects, but being outpatient before they manifested cut down her hospital stay significantly, which she found to be less stressful.
“Many patients like Myra may still require a hospitalization at some point during their treatment,” says Paul. “It should be comforting to patients and families that this option still is available should there be any concerns that they are not thriving at home or if they are having more significant complications.”
Learn more about outpatient cellular therapy at Levine Cancer.
