Introduction: CAR-T cell-based therapies, from the English "Chimeric Antigen Receptor T Cell Therapies", are new cellular immunotherapies used for the treatment of hematological neoplasms, refractory to therapy or relapsing pediatric and adult patients. Actually, the most significant results have been obtained in the treatment of type B lymphoblastic leukemia and B-cell non-Hodgkin's lymphoma (NHL). Many studies focus on multiple myeloma, chronic lymphocytic leukemia, and acute myeloid leukemia. Purpose: Conduct a review focused on the fundamental aspects of CAR-T therapy, with the final goal of highlighting the importance of the nursing figure in the various phases of the patient's therapeutic process. Materials and methods: The material was mainly taken from two databases: PubMed and Cinahl. Furthermore, the research was expanded through the reading of various books, mainly in Ebook format, the consultation of the Protocol about CAR-T patients of the Hematology department of the AOU Marche and of the Guidelines of the EBMT and of the AIFA. Results: After filtering the search and excluding articles unsuitable for review, 19 articles have been read and analyzed. The study highlights the structure of CAR-T, the various phases of the procedure and the possible complications related to the therapy. Furthermore, through an analysis of the centers available in Italy, the situation in the Marche region has been presented. It emerged that the figure of the nurse is present at all times of the therapy, from taking charge to long-term follow-up, and is mainly responsible for monitoring the patient following reinfusion. Conclusions: CAR-T cell therapy is constantly evolving and requires specialized and updated nursing knowledge. It is important that nurses in Oncology and Hematology departments are educated and informed about CAR-T patient management and about guideline changes. Key words: CAR-T, nursing, hematology, follow up.
Introduzione: Le terapie a base di cellule CAR-T, dall’inglese “Chimeric Antigen Receptor T Cell Therapies”, sono nuove immunoterapie cellulari usate per la cura delle neoplasie onco-ematologiche, refrattarie alla terapia o in recidiva sia nel paziente pediatrico che adulto. Ad oggi i risultati più significativi si sono ottenuti nel trattamento delle leucemie linfoblastiche di tipo B e dei linfomi non-Hodgkin a cellule B (LNH). Sono inoltre in atto molti studi per il mieloma multiplo, la leucemia linfatica cronica e la leucemia mieloide acuta. Scopo: Condurre una revisione centrata sugli aspetti fondamentali della terapia CAR-T, con l’obiettivo finale di evidenziare l’importanza della figura infermieristica nelle varie fasi del processo terapeutico del paziente. Materiali e metodi: Il materiale è stato principalmente ricercato su due banche dati: PubMed e Cinahl. Inoltre, la ricerca è stata ampliata attraverso la lettura di diversi libri, principalmente in formato Ebook, la consultazione del Protocollo di presa in carico del paziente CAR-T del reparto di Ematologia dell’AOU Marche e delle Linee Guida dell’EBMT e dell’AIFA. Risultati: Dopo aver filtrato la ricerca e aver escluso gli articoli non idonei ai fini della revisione, sono stati letti e analizzati 19 articoli. Lo studio ha messo in luce la struttura del CAR-T, le varie fasi della procedura e le possibili complicanze correlate alla terapia. Inoltre, attraverso un’analisi dei centri disponibili in Italia, è stata presentata la situazione all’interno della regione Marche. È emerso che la figura dell’infermiere è presente in ogni momento della terapia, dalla presa in carico al follow-up a lungo termine, ed è responsabile principalmente del monitoraggio del paziente a seguito della reinfusione. Conclusioni: La terapia con cellule CAR-T è in continua evoluzione e richiede conoscenze infermieristiche specializzate e aggiornate. È fondamentale che gli infermieri dei reparti di Oncologia ed Ematologia siano istruiti e informati sulla gestione dei pazienti CAR-T e sui cambiamenti delle linee guida. Parole chiave: CAR-T, nursing, hematology, follow up.
NURSING NEL PAZIENTE SOTTOPOSTO A CAR-T: UNA SPERANZA CONCRETA IN AMBITO EMATOLOGICO
TAMBURRANO, ARIANNA
2021/2022
Abstract
Introduction: CAR-T cell-based therapies, from the English "Chimeric Antigen Receptor T Cell Therapies", are new cellular immunotherapies used for the treatment of hematological neoplasms, refractory to therapy or relapsing pediatric and adult patients. Actually, the most significant results have been obtained in the treatment of type B lymphoblastic leukemia and B-cell non-Hodgkin's lymphoma (NHL). Many studies focus on multiple myeloma, chronic lymphocytic leukemia, and acute myeloid leukemia. Purpose: Conduct a review focused on the fundamental aspects of CAR-T therapy, with the final goal of highlighting the importance of the nursing figure in the various phases of the patient's therapeutic process. Materials and methods: The material was mainly taken from two databases: PubMed and Cinahl. Furthermore, the research was expanded through the reading of various books, mainly in Ebook format, the consultation of the Protocol about CAR-T patients of the Hematology department of the AOU Marche and of the Guidelines of the EBMT and of the AIFA. Results: After filtering the search and excluding articles unsuitable for review, 19 articles have been read and analyzed. The study highlights the structure of CAR-T, the various phases of the procedure and the possible complications related to the therapy. Furthermore, through an analysis of the centers available in Italy, the situation in the Marche region has been presented. It emerged that the figure of the nurse is present at all times of the therapy, from taking charge to long-term follow-up, and is mainly responsible for monitoring the patient following reinfusion. Conclusions: CAR-T cell therapy is constantly evolving and requires specialized and updated nursing knowledge. It is important that nurses in Oncology and Hematology departments are educated and informed about CAR-T patient management and about guideline changes. Key words: CAR-T, nursing, hematology, follow up.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/12895