Referral
Referring hospital: haematologist, oncologist, and administrative personnel
- Referring the patient to a hospital qualified in YESCARTA® treatment
- Seeking approval for the prescription of YESCARTA®
- Consideration of bridging therapy for the patient
Medical and clinical responsibility
Referring the patient to a hospital qualified in YESCARTA® treatment
Referring hospital: haematologist, oncologist, and administrative personnel
YESCARTA® treatment can only be given in qualified hospitals that have completed a training programme. In Finland, the qualified hospitals are; Helsinki University Hospital (HUS), Helsinki, and Oulu University Hospital, Oulu. Unless the patient is already under the care of one of these two hospitals, referral will be required.
It is important that patients who are potential candidates for YESCARTA® treatment are referred promptly because the process for approving the patient’s access to YESCARTA® and manufacturing the treatment takes a number of weeks.1
Seeking approval for the prescription of YESCARTA®
The referring physician needs to contact the Qualified treatment hospital for discussion and approval of
YESCARTA® for the patients.
Consideration of bridging therapy for the patient
Referring physician and treating physician
To ensure that the patient’s symptoms and disease are managed during the referral and approval period, the referring physician will consider whether the patient should receive treatment prior to YESCARTA®. Such treatment is called ‘bridging therapy’.1
Consideration of bridging therapy is important because disease progression and related adverse events could prevent the patient from receiving YESCARTA®.1 Conversely, certain treatments could jeopardize the collection of T cells required for the manufacture of YESCARTA®.1 For example, lymphotoxic combinations including bendamustine, fludarabine, cladribine, and pentostatin should be avoided, and immunosuppressive therapies and corticosteroids require a washout period.1,2
It is extremely important that the referring physician discusses bridging treatment options and timing with the treating hospital before these are prescribed.1
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Jain T, et al. Use of chimeric antigen receptor T cell therapy in clinical practice for relapsed/refractory aggressive B cell non-Hodgkin lymphoma: an expert panel opinion from the American Society for Transplantation and Cellular Therapy. Biol Blood Marrow Transplant 2019;25:2305-21.
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National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN Guidelines®): B-cell lymphomas, Version 2.2021. 16 February 2021.
Focus on the patient
Common patient questions
The requirement for referral to a different hospital may lead to apprehension for some patients. Their questions during the referral process may include:
- How long will the referral take?
- Why do I need to be referred to another hospital?
- Who decides whether or not I can be prescribed CAR-T treatment?
- If the request is successful, how long will it be before I receive CAR-T treatment?
- If the request is rejected, what alternative treatment options do I have?
- If the request is rejected, can we appeal?
Information for patients
If you would like patient-friendly information on YESCARTA® to help you to explain this treatment to patients, please Contact Us to make a request.
In addition, you may wish to provide to your patients the contact details of trusted patient groups for more information and support on CAR-T therapy.*
