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自体造血干细胞移植桥接 CAR-T 细胞治疗并发神经毒性综合征的管理:一例病例报告

英文原题:Management of neurotoxicity syndrome complicated by autologous hematopoietic stem cell transplantation bridge to chimeric antigen receptor T-Cell therapy: A case report.

查看英文原题

Management of neurotoxicity syndrome complicated by autologous hematopoietic stem cell transplantation bridge to chimeric antigen receptor T-Cell therapy: A case report.

PubMed 2023/12/27(内容时间) Asia Pac J Oncol Nurs Q1 · IF 3.3(JCR 2025)

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中文摘要

有效应对复发/难治性弥漫大B细胞淋巴瘤带来的挑战,特别是在采用自体造血干细胞移植和CAR-T 治疗时,需要综合的治疗和护理方法。本病例报告强调了一种聚焦于CAR-T 治疗后神经毒性管理的护理策略。护理干预包括神经毒性症状的识别、神经精神管理、腰椎穿刺和鞘内给药期间的细致支持、心理援助以及适应性营养指导。治疗和护理的严格执行使患者获得了显著康复,表现为中枢性面瘫减轻、吞咽功能改善(从4级改善至2级)以及发声增强。一致且专业的护理对于有效管理接受CAR-T 治疗患者的并发症,尤其是神经毒性,至关重要。全面的症状监测和个性化护理有助于优化治疗结果并确保患者安全。

展开英文摘要原文

Effectively addressing the challenges posed by relapsed and refractory diffuse large B-cell lymphoma, particularly when employing autologous hematopoietic stem cell transplantation and CAR-T therapy, requires a comprehensive approach to treatment and nursing. This case report emphasizes a nursing strategy focused on managing neurotoxicity post-CAR-T therapy. Nursing interventions include the identification of neurotoxicity symptoms, neuropsychiatric management, careful support during lumbar puncture and intrathecal administration, psychological assistance, and adaptive nutritional guidance.

The diligent application of treatment and nursing care resulted in a remarkable recovery for the patient, as evidenced by the alleviation of central facial paralysis, improvement in swallowing function (from Grade 4 to Grade 2), and enhanced vocalization. Consistent and specialized nursing care is paramount for effectively managing complications, especially neurotoxicity, in patients undergoing CAR-T therapy. A thorough monitoring of symptoms and personalized care contribute to optimizing treatment outcomes and ensuring patient safety.

论文信息

作者
Jiang P、Yang P、Wang W、Cao J、Chen W、Fu J、Lu L、Lu Y
单位
National Clinical Research Center for Hematologic Diseases, China.China
文献类型
病例报告
期刊
Asia-Pacific journal of oncology nursing2024 Mar
原文标识
PubMed 38426045 · DOI 10.1016/j.apjon.2023.100368