Objective

Chimeric antigen receptor (CAR) T-cell therapy is a genetically modified cellular therapy approved for the treatment of acute lymphocytic leukemia and B-cell lymphoma. This therapy requires patients to remain hospitalized for at least 7 days to monitor for two black-box warnings: cytokine release syndrome and neurotoxicity. Both toxicities require astute monitoring and early treatment to prevent complication.

Data Source

We use a case study to illustrate the assessment and toxicity management of a patient receiving CAR T-cell therapy for diffuse large B-cell lymphoma at an academic medical center.

Conclusion

Cytokine release syndrome and neurotoxicity are two common, potentially life-threatening toxicities that can be reversed with early nursing identification and treatment using evidence-based interventions.

Implications for Nursing Practice

Objective assessment and consensus grading is essential for identification and management of CAR T-cell toxicities.

中文翻译：

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嵌合抗原受体 T 细胞紧急情况：住院管理、评估和管理

客观的

嵌合抗原受体 (CAR) T 细胞疗法是一种经过基因改造的细胞疗法，被批准用于治疗急性淋巴细胞白血病和 B 细胞淋巴瘤。这种疗法要求患者住院至少 7 天，以监测两个黑框警告：细胞因子释放综合征和神经毒性。这两种毒性都需要敏锐的监测和早期治疗以预防并发症。

数据源

我们使用案例研究来说明在学术医疗中心接受 CAR T 细胞治疗的弥漫性大 B 细胞淋巴瘤患者的评估和毒性管理。

结论

细胞因子释放综合征和神经毒性是两种常见的、可能危及生命的毒性，可以通过使用循证干预的早期护理识别和治疗来逆转。

对护理实践的影响

客观评估和共识分级对于识别和管理 CAR T 细胞毒性至关重要。