Chimeric Antigen Receptor T-cell (CAR T-Cell) therapy is rapidly developing for the treatment of lymphoma and other cancers. This therapy is evolving quickly from bench to bedside, but there is limited oncology and intensive care nursing published literature. Patients can become critically ill very quickly and just-in-time education is not an ideal method for this new therapy.
A four-hour class was created to provide information for the bone marrow transplant (BMT) and intensive care unit (ICU) nurses. Content included a review of the immune system, assessment, CAR T-Cell complications including cytokine release syndrome and neurotoxicities, appropriate medications, and other available immunotherapies. The last topic presented was the nature and purpose of Phase 1 and Phase 2 clinical trials.
A four-hour immunotherapy class was created for BMT and ICU nurses with the following objectives:
The nurses have cared for 13 patients receiving this therapy. In the 9 patients who experienced CRS and neurological adverse reactions, they received appropriate interventions. All of the patients have been discharged to home.
Understanding and treating toxicities caused by the Immunotherapy CAR T-cell infusions are new to nursing and the medical staff. Just in time education for the management of this complex patient population is not ideal. Providing the bone marrow transplant and intensive care unit nurses with 4-hour education classes provided key information on this new biologic therapy. Because nurses attended these educational sessions they are able to recognize toxicities and anticipate required interventions which has optimized care for these patients.