Nursing care for patients who received monoclonal antibody therapy

Summary

Immunotherapy with monoclonal antibodies is a new type of leukemia treatment, gradually introduced into the practice of Russian hematological clinics. Most drugs are part of the extended access group, and do not have instructions in Russian. Aim of our work was to consider management and care of patients who received therapy with monoclonal antibodies, suggestion of recommendations for the nurses working with monoclonal antibody-based drugs.

Materials and methods

The study included 45 patients. All patients received treatment and were observed at the department of bone marrow transplantation No.1. The median of age was 8.7 years (4 months to 17 years). 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 – to 6 people, and 5 patients received Inotuzumab ozogamicin.

Results

62.2% of patients (n=28) had the febrile fever. After therapy with monoclonal AB, a compatible 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 receive HSCT. As of August 2018, 64.4% (n=29) of patients were alive.

Conclusions

Most patients were treated with monoclonal antibodies as the third line of therapy. The treatment and care of such patients require special attention. Also, in the absence of instructions in Russian, it is necessary to compile a procedure for preparing a solution with a monoclonal AB.

Keywords

Immunotherapy, Mylotarg, monoclonal antibodies, Blinatumomab, Inotuzumab.