淋巴瘤患者行干细胞移植联合CD30嵌合抗原受体T细胞输注治疗的护理
Nursing care of autologous stem cell transplantation combined with anti CD30 chi-meric antigen receptor T cell infusion for treatment of lymphoma patients
徐丽 1万滢 1阮海涛 1雷路 1陈琳1
作者信息
- 1. 华中科技大学同济医学院附属同济医院血液科(湖北武汉,430030)
- 折叠
摘要
目的 总结6例复发/难治性CD30阳性淋巴瘤患者进行自体干细胞移植联合抗CD30嵌合抗原受体T细胞输注治疗的护理经验.方法 对6例复发/难治性CD30阳性淋巴瘤患者,完善治疗前的护理评估,重点落实预处理毒性、细胞因子释放综合征以及植入综合征的护理,并将心理支持及健康教育纳入整个治疗过程.结果 6例患者均成功植入造血干细胞,外周血中检测到持续性CAR30转基因,其中5例完全缓解,1例部分缓解.5例出现细胞因子释放综合征,均为Ⅰ级,未观察到神经毒性.随访20.4(12.1,34.4)个月,患者均存活并保持其反应性.结论自体干细胞移植联合抗CD30嵌合抗原受体T细胞输注治疗具有良好的耐受性和高度活性,护理在治疗各阶段以及毒副反应管理中发挥重要作用.
Abstract
Objective To summarize the nursing experience of 6 patients with recurrent/refractory CD30 positive lymphoma under-going autologous stem cell transplantation combined with anti CD30 chimeric antigen receptor T cell infusion.Methods Six patients with recurrent/refractory CD30 positive lymphoma were evaluated for nursing care before treatment,focusing on the care of pre-treatment toxicity,cytokine release syndrome,and implantation syndrome.Psychological support and health education were inclu-ded in the entire treatment process.Results Hematopoietic stem cells were successfully implanted in all 6 patients.Persistent CAR30 gene transfer was detected in peripheral blood.Five cases had complete remission and 1 case had partial remission.Five pa-tients developed cytokine release syndrome,all of which were grade I,and no neurotoxicity was observed.At a median follow-up of 20.4(12.1,34.4)months,all patients survived and maintained their responsiveness.Conclusion Autologous stem cell transplanta-tion combined with anti CD30 chimeric antigen receptor T cell infusion therapy has good tolerance and high activity.Nursing plays an important role in various stages of treatment and in the management of toxic and side effects.
关键词
霍奇金淋巴瘤/间变性大细胞淋巴瘤/嵌合抗原受体T细胞/自体造血干细胞移植/细胞因子释放综合征/口腔黏膜炎/腹泻/血液病护理Key words
Hodgkin lymphoma/anaplastic large cell lymphoma/chimeric antigen receptor T cells/autologous hematopoietic stem cell transplantation/cytokine release syndrome/oral mucositis/diarrhea/hematology care引用本文复制引用
出版年
2024
NETL
NSTL
万方数据