Observation Points of the Disease After CAR-T Treatment for Lymphoma

Observation Points of the Disease After CAR-T Treatment for Lymphoma

As an emerging cancer treatment, chimeric antigen receptor T-cell (CAR-T) therapy has achieved significant therapeutic effects in the treatment of lymphoma. However, a series of adverse events may occur during the CAR-T treatment process, such as cytokine release syndrome, infections, neurotoxicity, and others. This article provides a review of the observation points for lymphoma patients after CAR-T cell infusion, aiming to enhance the understanding of CAR-T treatment-related adverse events among nursing staff and provide a reference for clinical nursing practice.

I. Overview of CAR-T Cell Therapy

CAR-T cell therapy is a cancer treatment modality based on the patient’s own immune cells. First, peripheral blood mononuclear cells are collected from the patient’s body, cultured and genetically modified ex vivo to express tumor-specific antigen receptors. The modified CAR-T cells are then infused back into the patient’s body to exert an anti-tumor effect. In recent years, CAR-T cell therapy has achieved remarkable therapeutic effects in the treatment of lymphoma, bringing new hope to patients.

II. Adverse Events and Observation Points in CAR-T Cell Therapy

1. Cytokine Release Syndrome (CRS)

Cytokine release syndrome is the most common adverse event in CAR-T cell therapy, with an incidence rate of approximately 60%-80%. The main clinical manifestations of CRS include fever, chills, fatigue, muscle pain, and in severe cases, respiratory distress, hypotension, and shock. Nursing staff should closely monitor the patient’s vital signs, such as body temperature, heart rate, and blood pressure, to promptly detect and manage CRS symptoms.

2. Infections

After CAR-T cell therapy, patients experience a weakened immune system, making them susceptible to infections. Infections can be of bacterial, viral, or fungal origin, with clinical presentations such as fever, cough, sputum production, and rash. Nursing staff should be vigilant for signs of infection, promptly perform microbiological tests, and provide targeted antibiotic treatment.

3. Neurotoxicity

Neurotoxicity is one of the more severe adverse events associated with CAR-T cell therapy, with an incidence rate of approximately 10%-20%. The main manifestations include headache, nausea, vomiting, and blurred vision. Nursing staff should closely monitor the patient’s neurological symptoms and promptly detect and manage neurotoxicity.

4. Hematological Toxicity

CAR-T cell therapy may cause hematological toxicity, such as anemia, leukopenia, and thrombocytopenia. Nursing staff should regularly monitor complete blood counts and be aware of signs of anemia, infection, and bleeding, providing timely and appropriate treatment.

5. Tumor Lysis Syndrome

Tumor lysis syndrome occurs when large numbers of tumor cells are lysed during the CAR-T treatment process, releasing intracellular toxins and leading to electrolyte imbalances and acid-base disturbances. Clinical manifestations include nausea, vomiting, diarrhea, and hypotension. Nursing staff should closely monitor the patient’s electrolyte levels and acid-base balance, promptly detecting and managing tumor lysis syndrome.

6. Hepatic and Renal Toxicity

CAR-T cell therapy may cause hepatic and renal toxicity, manifesting as abnormal liver function and impaired renal function. Nursing staff should monitor the patient’s liver and kidney function indicators, promptly detecting and managing hepatic and renal toxicity.

III. Nursing Measures

1. Closely monitor the patient’s vital signs and promptly detect and manage adverse events.

2. Provide psychological nursing care to alleviate the patient’s anxiety and fear.

3. Maintain patency of the patient’s airway and provide oxygen therapy if necessary.

4. Enhance nutritional support to improve the patient’s immune function.

5. Strictly follow the principles of anti-infective treatment and provide timely targeted antibiotic therapy.

6. Provide appropriate nursing care for adverse events such as tumor lysis syndrome and neurotoxicity.

7. Monitor liver and kidney function and promptly detect and manage hepatic and renal toxicity.

IV. Conclusion

CAR-T cell therapy has achieved significant therapeutic effects in the treatment of lymphoma, but a series of adverse events may occur during the treatment process. Nursing staff should closely monitor the patient’s condition, understand the observation points for adverse events, promptly detect and manage them, to enhance the safety and effectiveness of CAR-T cell therapy. Additionally, strengthening psychological nursing care, nutritional support, and other aspects of care can improve the patient’s quality of life.

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