Referral information
Please complete the CAR-T referral form and submit the completed form following the instructions provided.
In addition, please attach the following:
- Referral letter stating the date of diagnosis/transformation, prior lines of treatment and response, and any active or chronic comorbidities and medications
- Recent or relevant PET/CT/MRI reports (screenshot of PET images if possible)
- Recent TTE or MUGA if available
- Relevant histopathology reports
- Recent FBE, EUC and LFTs
Once the patient referral has been submitted, referrals will be triaged by one of our CAR-T Haematologists and you and your patient will be contacted.
Patients will be required to be reviewed in person in our CAR-T clinic to assess eligibility, along with any screening investigations if not already performed.
All new referrals will be discussed at the Alfred multidisciplinary meeting as well as the National CAR-T multidisciplinary meeting.