1347 - Baseline Mobility Matters: Guiding Early Rehabilitation in CAR-T Recipients

Objectives: Chimeric Antigen Receptor T-cell (CAR-T) therapy is transformative for refractory hematologic malignancies but often leads to functional decline, intensive care unit (ICU) use, and prolonged hospitalization. Identifying high-risk patients is key for rehabilitation triage. This study aimed to evaluate whether baseline mobility, measured by the AM-PAC “6-Clicks” Basic Mobility Short Form, is associated with length of stay (LOS), ICU admission, in-hospital mortality, and incidence of Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) in CAR-T recipients.

Design: Retrospective cohort of 54 adults receiving inpatient CAR-T (May–Dec 2024, single center). Patients were grouped as Low Basic Mobility  (AM-PAC < 20; n = 7), Higher Basic  Mobility (≥ 20; n = 20), or Independent Mobility (no PT consult; n = 27). Baseline mobility was measured with the AM-PAC Mobility Form (six tasks: bed mobility, transfers, sit-to-stand, walking, steps). Outcomes analyzed by mobility group: LOS, ICU admission, in-hospital mortality, and ICANS.

Results:

Among 54 adults (mean age 59; 56% male) receiving CAR-T, lymphoma (46%) and plasma cell dyscrasias (38%) predominated. Mean BMI: Low Basic 21.2, Higher Basic 26.3, Independent 25.4. Medicaid coverage: Low Basic 29%, Higher Basic 15%, Independent 0%.

Outcomes by baseline mobility: length of stay Low Basic 21.8 vs. Higher Basic 13.9 vs. Independent 10.8 days (F = 9.3, p < 0.001); ICU admission Low Basic 42.9% vs. Higher Basic 0% vs. Independent 0% (χ² = 14.2, p = 0.001); in-hospital mortality Low Basic 28.6% vs. Higher Basic 0% vs. Independent 0% (χ² = 14.2, p = 0.001); ICANS ≥1 Low Basic 71.4% vs. Higher Basic 40.0% vs. Independent 40.7% (χ² = 5.6, p = 0.06).

Conclusions:

Low mobility patients had longer stays, higher ICU use, and greater mortality. They also had lower BMI and more Medicaid coverage, reflecting social vulnerability. Routine AM-PAC screening may support early rehabilitation. Limitations include retrospective, single-center design and small sample.