THE ROLE OF NURSING IN CAR-T CELL THERAPY: IMMUNOLOGICAL BASICS, CLINICAL PRACTICE, AND CARE MANAGEMENT

• DOI: https://doi.org/10.22533/at.ed.51572926170411

• Palavras-chave: Nursing, CAR-T Therapy, Nursing Care.

• Keywords: Nursing, CAR-T Therapy, Nursing Care.

• Abstract:

  Chimeric Antigen Receptor T-cell (CAR-T) therapy represents an innovation in the treatment of hematologic malignancies, with high response and remission rates in diseases such as leukemias, lymphomas, and multiple myeloma. This study aimed to analyze the immunological foundations of CAR-T therapy, its clinical application, and the role of nursing in the management of patients undergoing this therapeutic approach. This is a descriptive review that addresses aspects related to therapeutic efficacy, major adverse events—with a focus on cytokine release syndrome (CRS) and associated neurotoxicity (ICANS)—and the nursing interventions required for monitoring and managing these complications. It was demonstrated that nursing plays an essential role in all stages of treatment, from preparation and infusion to longitudinal follow-up, acting in health education, clinical monitoring, and the implementation of systematized care through the Systematization of Nursing Care (SAE). In addition, bioethical aspects, challenges related to the high cost of therapy, and limitations—especially in the treatment of solid tumors—are discussed. Future prospects include advances in genetic engineering, such as the use of CRISPR technology, the development of allogeneic (off-the-shelf) therapies, therapeutic combinations, and the use of other immune system cells, such as NK cells and macrophages. It is considered that CAR-T therapy has high therapeutic potential, requiring qualified nursing practice to ensure safety and quality in the care of cancer patients.