Nursing care for patients who received therapy with monoclonal antibodies
Immunotherapy with monoclonal antibodies (Mabs) is a new type of leukemia treatment, being gradually introduced into the practice of Russian hematological clinics. Most drugs comprise a part of the extended access group, and do not have instructions in Russian. Aim of the present study was to consider the strategy of care for the patients who received therapy with monoclonal antibodies, and to suggest recommendations for the nurses working with monoclonal antibodies.
Materials and methods
The study included 45 patients. All the patients received treatment and medical care in the BMT Department No.1, at the R.Gorbacheva Memorial Institute for Children Oncology, Hematology and Transplantation. Their median age was 8.7 years (4 months to 17 years old). Acute lymphoblastic leukemia (ALL) was diagnosed in 80% (n=36), acute myeloblastic leukemia (AML) was found in 13.3% (n=6), and acute biphenotypic leukemia was detected in 6.7% (n=3) (ABL). The therapy with Blinatumomab was applied to 36 patients, Mylotarg was administered in 6 cases, and 5 patients received Inotuzumab ozogamicin.
62.2% of the patients (n=28) exhibited febrile fever. After therapy with Mabs, a related hematopoietic stem cell transplantation (HSCT) was performed for 35.5% of patients (n=16), 26.7% of patients (n=12) received haploidentical HSCT, and 37.8% (n=17) did not underwent HSCT. Against the August 2018, 64.4% (n=29) of patients were alive.
Most patients were treated with monoclonal antibodies as the third-line therapy. Treatment and care for such patients require special attention. Also, in the absence of instructions in Russian language, it is necessary to compile an operation procedure for preparing a solution with monoclonal antibodies.
Immunotherapy, Mylotarg, monoclonal antibodies, Blinatumomab, Inotuzumab.