Reimagine Care, Center for Cancer and Blood Disorders Offer Key Support Layer in Crucial Weeks After CAR T-Cell Therapy

Your husband has an aggressive form of large B-cell lymphoma, and he is out of remission. The best option is CAR T-cell therapy, which will cost $1 million by the time all the bills come in. He’s been through the cell collection, the weeks of waiting, and several days of “bridge chemo” to get ready for the big day. After all that, the hourlong infusion of T cells seems anticlimactic.

And now, you both wait.

It will be around day 5 or 6 before signs of cytokine release syndrome (CRS) emerge. If you’re the caregiver—and that’s required for a patient to receive chimeric antigen receptor (CAR) T-cell therapy—you take your spouse’s temperature while watching for signs of fatigue, chills, or gastrointestinal and cognitive symptoms that demand intervention.

The waiting happens close to the clinic, likely at home if you live nearby.

Unless you’re a doctor or a nurse, which is unlikely, you wonder: “What am I looking for?” You worry, and you’re not alone.

As more patients become eligible for CAR T-cell therapy or bispecific antibodies to treat lymphoma or multiple myeloma, the unease that caregivers feel, their lack of availability, and the fears patients have about putting loved ones under stress, are all reasons many opt against CAR T.¹

Dan Nardi, CEO of the virtual oncology platform Reimagine Care, looked at the numbers and was determined to do something.

“These CAR T therapies are amazing, truly life-changing. It's the closest thing we've come to a cure, and the fact that only 20% of patients who are eligible for these are currently getting them is still mind-boggling,”² Nardi said in an interview with The American Journal of Managed Care.^®

In late June, Reimagine Care and The Center for Cancer and Blood Disorders (CCBD), a large community oncology practice in Texas, announced plans to expand their existing collaboration to support patients receiving advanced cell therapies, including CAR T-cell therapy, through Reimagine Care's Advanced Therapy Management (ATM) program. CCBD treats more than 20,000 patients annually across 16 locations, including its Fort Worth campuses, and the ATM program is designed to give the practice's oncology team continuous visibility into how patients are doing once they leave the clinic.³

The expansion builds on an existing collaboration between the 2 organizations that has already generated a substantial track record: Reimagine Care has supported more than 6100 unique patients and logged over 220,000 interactions between its AI-powered virtual assistant, called Remi, and clinicians in its Virtual Care Center. Engagement has remained high over time: 93% of patients use the symptom management program in the first 30 days, 80% are still active at 90 days, and 65% remain engaged at 6 months. More than 90% of patient encounters are resolved by Reimagine Care without escalation to CCBD's care team; when escalation is needed, the average response time is under 10 minutes. Across the collaboration, avoidable emergency department visits during patients' first 6 months of treatment have dropped 55%.³

Those numbers matter more, not less, once CAR T-cell therapy enters the picture. CRS can progress from mild symptoms to a medical emergency within hours,⁴ and the ATM program is built around that timeline: daily virtual monitoring during the highest-risk postinfusion period, remote vital sign tracking, neurocognitive evaluations, and escalation pathways defined specifically for CRS and immune effector cell–associated neurotoxicity syndrome (ICANS), coordinated in real time with CCBD's oncology team.

“CAR-T patients require an extraordinary level of coordination and vigilance, especially in the first several weeks after treatment,” Barry Russo, the longtime CEO of CCBD, said in a statement announcing the collaboration, after he worked to pass legislation that would make it easier for community practices to administer CAR T.

“This collaboration allows us to extend our reach beyond the walls of the clinic and maintain close visibility into how patients are doing between visits,” he said. “That's increasingly important as advanced therapies become more common in community oncology.”³

Caregiver Confidence as a Clinical Variable

For Nardi, the caregiver relationship is not a peripheral concern in CAR T-cell delivery. It is one of the variables determining whether an eligible patient receives the therapy at all. In the AJMC interview, he pointed to the study about how patients decide whether to pursue CAR T—research that has stayed with him.¹

The dynamic of a capable, willing patient held back by a caregiver's fear of being unable to recognize or respond to a complication at home is precisely what the ATM program is designed to address. Connected devices track blood pressure, pulse oximetry, and temperature several times a day; Remi pairs those readings with symptom check-ins delivered by text; and a nurse is available behind all of it.

“Having something like this right at your fingertips, whether it's the patient or the caregiver, is amazing — the peace of mind of getting answers within seconds really helps remove that burden,” Nardi said. He added that in patient surveys, the most common feedback Reimagine Care hears is a version of the same sentiment: “Knowing that someone has my back, knowing that someone is always there—that's probably the number one biggest thing.”

From the Inpatient Bed to the Living Room

The caregiver-confidence question is also an outpatient-conversion question. Until relatively recently, CAR T-cell therapy typically required an inpatient stay of several weeks, and clinical trials with the therapy were all done this way. The movement toward outpatient administration and community oncology for both CAR T and bispecific is rooted in the fact that patients avoid the infection risk that comes with a prolonged hospital admission, and patients tend to recover faster in familiar surroundings.⁵ But that shift only works if patients and caregivers trust that deterioration will be caught quickly, wherever they happen to be.

CCBD has treated 3 patients under the expanded CAR T program so far, a deliberately small number as the organizations refine the workflow before scaling. Nardi said Reimagine Care and CCBD ultimately intend to track how programs like ATM affect the calculus physicians already use when deciding whether a given patient can safely be managed outside the hospital; this includes those who fall into a gray zone of frailty balanced against caregiver capability.

Built to Scale Without Adding Staff

The practice-side case for ATM rests on the same technology-plus-human model. Without connected devices and an AI assistant handling routine check-ins, Nardi said, monitoring CAR T patients this closely would require nurses to call several times a day, and this workload simply won’t scale as more practices bring cell therapy into the community.

“We're using technology and the right combination of human in the loop at the right time to connect with these patients. That's going to allow us to do this in a more scalable manner,” Nardi said. Reimagine Care also absorbs the logistics of shipping and activating monitoring devices, he said, so that clinical staff can focus on care rather than fulfillment: “They're clinicians. They want to support care. They're not in a logistics, Amazon-shipping kind of mindset.”

That framing echoed themes Nardi raised in April at the Community Oncology Alliance's Community Oncology Conference, where he described Remi as a persistent “care layer” between patients and their practice—one designed to extend clinical reach without adding to physician or nursing burden, a concern that ran throughout that conference's broader discussion of AI adoption in community oncology.⁶

Closing an 80% Gap

Nardi framed the CCBD collaboration as one piece of a larger access problem. With roughly 4 in 5 eligible patients still not receiving CAR T-cell therapy, he said the reasons extend well beyond caregiver hesitation to include financial barriers, insurance coverage, and geographic access to certified treatment centers.

Reimagine Care expects several additional health systems to become active development partners in the ATM program later this year, with CCBD's program currently centered on axicabtagene ciloleucel (Yescarta; Kite/Gilead) while the practice explores adding other CAR T-cell products.

Nardi wants to see the issue of CAR T access get more attention.

“For all the impact we talked about—the life-changing therapies this is having—we need to be talking about this more,” he said. “We need to be getting this to more practices, so they can bring it to more patients. That's the huge opportunity we have right now.”

References

1. Hydren JR, Lin D, Sweeney NW, et al. Patient perspectives on BCMA-targeted therapies for multiple myeloma: a survey conducted in a patient advocacy group. Front Health Serv. 2024;4:1354760. doi:10.3389/frhs.2024.1354760
2. CAR T Vision. Accessed July 1, 2026. https://cartvision.com/executive-summary/
3. Reimagine Care and The Center for Cancer and Blood Disorders redefine support for patients on advanced cancer therapies. News release. BusinessWire. June 23, 2026. Accessed June 30, 2026. https://www.businesswire.com/news/home/20260623195977/en/Reimagine-Care-and-The-Center-for-Cancer-and-Blood-Disorders-Redefine-Support-for-Patients-on-Advanced-Cancer-Therapies
4. Porter D, Frey N, Wood PA, Weng Y, Grupp SA. Grading of cytokine release syndrome associated with the CAR T cell therapy tisagenlecleucel. J Hematol Oncol. 2018;11(1):35. doi:10.1186/s13045-018-0571-y.
5. Gomez A, Abrahim S, Caliendo T. Outpatient CAR T therapy revolutionizing cancer treatment. US Pharmacist. April 15, 2025. Accessed July 1, 2026. https://www.uspharmacist.com/article/outpatient-cart-therapy-revolutionizing-cancer-treatment
6. Caffrey M. AI in oncology practice: Innovation in the delivery of care itself. AJMC. May 1, 2026. Accessed July 1, 2026. https://www.ajmc.com/view/ai-in-oncology-practice-innovation-in-the-delivery-of-care-itself