血液恶性肿瘤CAR-T治疗后患者报告结局的范围综述  

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

作　　者：毛奕文 黄丽红 阮海涛 瞿茜 吴德芳 蔡兴奥 Mao Yiwen;Huang Lihong;Ruan Haitao;Qu Xi;Wu Defang;Cai Xingao(Nursing Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院护理部 [2]华中科技大学同济医学院护理学院

出　　处：《护理学杂志》2023年第24期99-104,共6页Journal of Nursing Science

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。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.

关 键 词：血液恶性肿瘤 患者报告结局 健康结果 嵌合抗元受体 CAR-T细胞疗法 护理评估 范围综述 

分 类 号：R473.73[医药卫生—护理学]