血液恶性肿瘤CAR-T〖WT〗治疗后患者报告结局的范围综述
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女,硕士在读,学生

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Self-reported outcomes in patients with hematological malignancies undergoing CAR-T therapy:a scoping review
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    摘要:

    目的 对血液恶性肿瘤嵌合抗原受体T细胞(CAR-T)治疗的急性、亚急性及长期随访期间患者报告结局研究进行范围综述,为临床早期判断和实施干预提供参考。方法 检索中英文数据库中血液恶性肿瘤CAR-T治疗后患者报告结局的相关研究,检索时限为建库至2023年3月20日。对纳入文献进行筛选及汇总分析。结果 共纳入16篇文献。现有研究共使用18种评价工具测量CAR-T治疗后患者报告结局,测量范围包括症状、功能性及心理状态评估。CAR-T治疗后急性期患者突出报告症状领域恶化;亚急性患者突出报告社会及角色功能的持续限制以及疲劳、疼痛、睡眠障碍症状;长期随访患者报告神经系统症状或焦虑、抑郁情绪。结论 不同时期CAR-T治疗患者报告结局存在差异,提示医护人员应长期监测。未来可开发CAR-T治疗血液恶性肿瘤患者特异性评价工具,利用电子化患者报告结局建立数字健康监测系统。

    Abstract:

    Objective To review the patient-reported outcomes during the acute, subacute, and long-term follow-up stages of chimeric antigen receptor T-cell (CAR-T) therapy in patients with hematologic malignancies, so as to provide a reference for early clinical judgment and intervention. Methods Domestic and international electronic databases were searched for studies on self-reported outcomes of patients with hematological malignancies subsequent to CAR-T therapy from data base construction until 20 March 2023. The included studies were screened, summarized and analyzed. Results A total of 16 studies were included and 18 evaluation tools were used to measure patient-reported outcomes after CAR-T therapy, and the measure ranges included symptoms, functional capacity and psychological well-being. Patients in the acute phase mainly reported a deterioration in symptom areas following CAR-T therapy, subacute patients frequently reported enduring impairments in social and occupational function, alongside symptoms of fatigue, pain, and sleep disturbances, and their counterparts undergoing long-term follow-up commonly reported neurological symptoms, anxiety or depression. Conclusion Variation exists in self-reported outcomes in patients undergoing different phases of CAR-T therapy, so it is necessary to conduct continuous monitoring by healthcare practitioners. Future research should develop a dedicated assessment tool to evaluate the efficacy of CAR-T therapy in patients with hematological malignancies, and establish a digital health monitoring system using electronic patient-reported outcomes.

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毛奕文,黄丽红,阮海涛,瞿茜,吴德芳,蔡兴奥.血液恶性肿瘤CAR-T〖WT〗治疗后患者报告结局的范围综述[J].护理学杂志,2023,38(24):99-104

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  • 收稿日期:2023-07-20
  • 最后修改日期:2023-09-20
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  • 在线发布日期: 2024-01-13