CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Beyond the infusion: nursing at the vanguard of cytokine release syndrome rescue in CAR-T cell therapy.
Beyond the infusion: nursing at the vanguard of cytokine release syndrome rescue in CAR-T cell therapy.
分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。
嵌合抗原受体(CAR)T细胞疗法改变了肿瘤治疗,但也带来一种可能致命的毒性:细胞因子释放综合征(CRS)。尽管研究重点常放在药物干预上,护理人员在一线识别、管理并抢救CRS患者方面发挥关键作用,但文献对此重视不足。本叙述性综述综合现有证据,正式阐明护理在CRS救治中的前沿作用。文章介绍复杂的CRS免疫生物学,为高级实践护理提供基础,并解析其临床表现谱,以支持精准评估。综述提出一个新的四支柱框架,概述护理在输注前准备、严密预测性监测、按严重程度分级并依算法干预,以及多学科协调中的关键作用。此外,文章率先探讨CRS特异性护理敏感结局(NSO)的界定,以量化护理对患者安全和疗效的影响。最后,综述展望床旁检测和专科护理岗位等未来方向,倡导范式转变,使护理人员被认可为优化CAR-T 治疗安全性、充分释放其潜力的重要领导者。
Chimeric antigen receptor (CAR) T cell therapy has revolutionized oncology but is fraught with a potentially lethal toxicity: cytokine release syndrome (CRS). While much focus is placed on pharmaceutical interventions, the pivotal role of nursing in the frontline detection, management, and rescue of patients from CRS remains under-championed in the literature. This narrative review synthesizes the current evidence to formally position nursing at the vanguard of CRS rescue.
We delineate the intricate immunobiology of CRS as a primer for advanced practice and deconstruct its clinical spectrum to empower precise assessment. A novel four-pillar framework is presented, outlining nursing's critical role in pre-infusion preparedness, vigilant predictive monitoring, graded algorithm-driven intervention, and multidisciplinary coordination.
Furthermore, we pioneer the discussion on defining nursing-sensitive outcomes (NSOs) specific to CRS to quantify nursing's impact on patient safety and efficacy.
Finally, we explore future directions, including point-of-care testing and specialized nursing roles, advocating for a paradigm shift where nurses are recognized as essential leaders in optimizing safety and unlocking the full potential of CAR-T cell therapy.
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