Relevant nursing measures for the adverse reactions associated with chimeric antigen receptor T cells (CAR-T) immunotherapy: a systematic review of case reports†
, and | Jul 10, 2019
About this article
Article Category: Original article
Published Online: Jul 10, 2019
Page range: 87 - 95
Received: Oct 03, 2018
Accepted: Dec 22, 2018
DOI: https://doi.org/10.2478/FON-2019-0014
Keywords
© 2019 Xu Zhang et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
Figure 1
Baseline characteristics of the studies included in the systematic review.
| Authors | Study design | Sample size | Cancer type | Treatment plan | Adverse reactions | Nursing intervention | Results |
|---|---|---|---|---|---|---|---|
| Chen et al. 201614 | Case report | B-ALL ( | Pretreatment Cycl+Flud CAR-T dose 50 mL (1×106/kg) | CRS ( | Monitored changes in temperature and blood pressure Monitored vital signs, renal function, and neurological signs, and recorded output and input | CRS is controlled NA | |
| Ding et al. 201717 | Case report | Neuroblastoma ( | Pretreatment Cycl or Flud | CRS Fever ( | Physical or drug cooling, and monitored temperature | Body temperature returned to normal | |
| CAR-T dose NM | Hypotension ( | Monitored blood pressure and gave dopamine Informs the patient not to scratch the skin and smear calamine lotion Continuous ECG monitoring Saline and chlorhexidine gargle alternate gargling Oxygen inhalation, gave diuretic, and recorded output and input | Blood pressure returned to normal after 3 days After 1 week, the exanthema subsided. NA Absorbed inflammation remission after 7 days and 5 days after the pleural effusion | ||||
| Feng et al. | Case | B-ALL ( | Pretreatment | Fever | Gave antibiotics and | NM | |
| 201615 | report | (female) | Cycl+Flud | Hypotension | physical cooling | NM | |
| CAR-T dose NM | Pain | Monitored blood pressure, and gave boost medicine Evaluated the nature of pain and gave analgesic drugs | NM | ||||
| Li and Wan 201716 | Case report | B-ALL ( | Pretreatment Cycl+Flud CAR-T dose 2×106/kg | Fever ( | Cold compress ice bag for physical cooling Monitored blood pressure and gave boost medicine Oxygen inhalation Turn over, massage, and smear skin protectant Infused red blood cells and platelets | After 6 hours, temperature dropped to normal Blood pressure returned to normal SpO2 stable at 95–98% After 2 days, the ulcer healed Hemoglobin and platelets increased significantly | |
| Yu 201712 | Case report | Neuroblastoma ( | Pretreatment Cycl+Flud CAR-T dose 10–15 mL | CRS ( | Physical or drug cooling, and monitored temperature | Returned to normal after 7–14 days of fever | |
| Zhang et al. | Case report | B-ALL ( | Pretreatment NM | CRS ( | Closely monitored vital signs and physical or | Body temperature dropped to normal | |
| 201613 | 2 males) | CAR-T total | Hyperuricemia | drug cooling | NM | ||
| dose 5×108–11×108 | ( | Closely observed changes in indicators such as output and input and biochemical | NM |
Assessment of the quality of case report included in the present study.
| Study | Chen et al. 201614 | Ding et al. 201717 | Feng et al. 201615 | Li and Wan 201716 | Yu 201712 | Zhang et al. 201613 |
|---|---|---|---|---|---|---|
| Is the hypothesis/aim/objective of the study clearly stated? | Yes | Yes | Yes | Yes | Yes | Yes |
| Are the characteristics of the participants included in the study described? | Yes | Yes | Yes | Yes | Yes | Yes |
| Were the cases collected in more than one center? | No | No | No | No | No | No |
| Are the eligibility criteria for entry into the study clearly stated? | No | Yes | No | No | Partially reported | No |
| Were participants recruited consecutively? | Unclear | Unclear | Unclear | Unclear | Yes | Unclear |
| Did participants enter the study at a similar point in the disease? | Yes | Yes | Yes | Yes | Yes | Yes |
| Was the intervention of interest clearly described? | Yes | Yes | Yes | Yes | Yes | Yes |
| Were additional interventions (co-interventions) reported in the study? | Yes | Yes | Yes | Yes | Yes | Yes |
| Are the outcome measures established a priori? | Yes | Yes | No | Yes | Yes | No |
| Were the relevant outcomes measured with appropriate objective and/or subjective methods? | Yes | Yes | Yes | Yes | Yes | Yes |
| Were the relevant outcomes measured before and after the intervention? | Yes | No | Yes | No | No | Yes |
| Were the statistical tests used to assess the relevant outcomes appropriate? | Unclear | Unclear | Unclear | Unclear | Unclear | Unclear |
| Was the length of follow-up reported? | No | No | No | No | No | No |
| Was the loss to follow up reported? | Yes | Yes | Yes | Yes | Yes | Yes |
| Does the study provide estimates of the random variability in the data | No | No | No | No | No | No |