P-484: Successful incorporation of ePRO using PROMIS-29 into standard of care after hematopoietic stem cell transplant and chimeric antigen receptor T cell therapy for plasma cell dyscrasias.

Introduction: Autologous hematopoietic stem cell transplant (AHCT) and chimeric antigen receptor T cells (CAR T) are mainstays of treatment for multiple myeloma (MM), but often have significant and prolonged side effects. Patient-reported outcome (PRO) measures allow for self-reporting of symptoms to the care team and are more comprehensive and reliable than provider-based assessments. Using our center’s electronic platform, we aimed to integrate PRO collection into standard-of-care to improve the clinical experience after HCT and CAR T.

Methods: Patients received the PROMIS-29 survey through a patient portal. Baseline surveys were automatically generated by a chemotherapy order, and follow-up surveys on Day 0 (infusion), weekly for the first month, monthly for the first year, and every 3 months for the second year were generated based on the date of the cell infusion order. Survey responses in pre-identified severe ranges prompted instructions to call the clinician’s office and for the clinical team to call the patient. Scores are standardized against US normative population data producing T scores with a mean of 50 and a standard deviation of 10.

Results: From November 2020 to December 2022, 335 patients underwent a commercial cell therapy at MSK (326 MM, 9 AL amyloidosis, 309 AHCT infusions, 33 CAR T) with overall median age of 64 (range 27-81) and 46% female. At least one survey was completed by 85% of patients with AHCT, with response rates at baseline, Day 0, week 1, week 2, week 3, week 4, and Day 90 of 61%, 38%, 39%, 34%, 38%, 40%, and 36%, respectively. PROMIS-29 physical health summary scores at baseline, Day 0, week 1, week 2, week 3, week 4, and Day 90 were 47 [21-59], 45 [23-59], 44 [22-59], 42 [21-59], 41 [22-59], 42 [22-59], and 46 [29-59], respectively. Mental health summary scores were 51 [31-64], 49 [30-64], 49 [31-64], 48 [27-64], 48 [31-64], 49 [30-64], and 52 [26-64], respectively. For the CAR T patients, 64% answered at least one survey, with response rates at baseline, Day 0, week 1, week 2, week 3, week 4, and Day 90 of 39%, 12%, 21%, 27%, 24%, 21%, and 9%, respectively. PROMIS-29 physical health summary scores at baseline, Day 0, week 1, week 2, week 3, week 4, and Day 90 were 43 [27-57], 40 [27-46], 45 [38-59], 44 [35-59], 51 [35-59], 45 [34-58], and 37 [34-58], respectively. Mental health summary scores were 48 [36-59], 46 [40-50], 49 [45-63], 51 [38-62], 52 [36-64], 52 [48-62], and 45 [39-63], respectively.

Conclusions: We demonstrate the feasibility of incorporating patient-reported outcomes into standard-of-care practice after AHCT and CAR T. Missing surveys were more common while inpatient, which may be due to toxicity and/or less frequent use of the patient portal while admitted. Additional work is ongoing to improve the response rates at all time points. Importantly, the electronic system allowed us to capture later timepoints when patients have less frequent visits and may be followed locally. Full survey results will be presented.