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超越输注:护理在 CAR-T 细胞治疗细胞因子释放综合征救治中的前沿地位

英文原题:Beyond the infusion: nursing at the vanguard of cytokine release syndrome rescue in CAR-T cell therapy.

查看英文原题

Beyond the infusion: nursing at the vanguard of cytokine release syndrome rescue in CAR-T cell therapy.

PubMed 2025/10/30(内容时间) Clin Transl Oncol Q3 · IF 2.7(JCR 2025)

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。

中文摘要

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。

展开英文摘要原文

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.

论文信息

作者
Zuo R、Han M
第一作者单位
Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang, 76231, Hebei, China.China
通讯作者单位
Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang, 76231, Hebei, China. hanmeijie2025@126.com.China
文献类型
综述
期刊
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026 Apr
原文标识
PubMed 41166025 · DOI 10.1007/s12094-025-04087-6