HCT & CAR T Access: Unseen Barriers & Inequities in Care
Hannah Abrams, MD, discusses the background behind research into nonmedical barriers to cell transplant and CAR T therapy.
A study led by Hannah Abrams, MD, fellow in hematology-oncology at Fred Hutch Cancer Center, investigated nonmedical requirements for hematopoietic cell transplantation (HCT) and chimeric antigen receptor (CAR) T-cell therapy across US academic centers. A national survey of 31 institutions (91% response rate) revealed significant variability in caregiver requirements (duration and support), local housing and transportation expectations (distance and duration), and cell phone access.
Notably, "all-outpatient" protocols had stricter logistical criteria. Many centers reported excluding patients with histories of medication nonadherence, substance use, or psychiatric comorbidities, often without formal review processes or defined paths to regain eligibility. Institutions identified caregiving, housing, cost, and insurance as major nonmedical barriers.
The authors conclude that the lack of standardized nonmedical policies creates potential inequities in access to these therapies and recommend formal tracking of reasons for noneligibility to inform interventions aimed at improving access and equity.
In an interview with Targeted OncologyTM, Abrams discussed the background and goals of this research.
