Chinese Journal of Emergency and Critical Care Nursing >
Nursing care for a patient with plasma cell disease undergoing chimeric antigen receptor T-cell immunotherapy complicated with cytokine release syndrome
This article summarized the nursing experience of a patient with plasma cell disease who developed cytokine release syndrome（CRS） following chimeric antigen receptor T-cell（CAR-T） therapy. The patient exhibited severe clinical manifestations of CRS，including altered mental status，chills with high fever，hypotension，and pancytopenia. A comprehensive nursing approach was implemented，which included rigorous monitoring of the patient’s condition，prompt initiation of emergency response protocols，circulatory support，continuous renal replacement therapy（CRRT），and infection prevention. As a result of these measures，the patient was successfully treated and discharged. Follow-up revealed that the patient had a good quality of life.
LI Ying , ZHU Yan , ZENG Fei . Nursing care for a patient with plasma cell disease undergoing chimeric antigen receptor T-cell immunotherapy complicated with cytokine release syndrome[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025 , 6(10) : 1220 -1222 . DOI: 10.3761/j.issn.2096-7446.2025.10.012
| [1] | He CH, Mansilla-Soto J, Khanra N, et al. CD19 CAR antigen engagement mechanisms and affinity tuning[J]. Sci Immunol, 2023, 8(81):eadf1426. |
| [2] | Xiao XY, Huang SK, Chen SF, et al. Mechanisms of cytokine release syndrome and neurotoxicity of CAR T-cell therapy and associated prevention and management strategies[J]. J Exp Clin Cancer Res, 2021, 40(1):367. |
| [3] | Porter DL, Levine BL, Kalos M, et al. Chimeric antigen recep-tor-modified T cells in chronic lymphoid leukemia[J]. N Engl J Med, 2011, 365(8):725-733. |
| [4] | Xing XY, Hu XY. Risk factors of cytokine release syndrome:stress,catecholamines,and beyond[J]. Trends Immunol, 2023, 44(2):93-100. |
| [5] | Browne EK, Daut E, Hente M, et al. Evidence-based recommen-dations for nurse monitoring and management of immuno-therapy-induced cytokine release syndrome:a systematic review from the children’s oncology group[J]. J Pediatr Oncol Nurs, 2021, 38(6):399-409. |
| [6] | Morris EC, Neelapu SS, Giavridis T, et al. Cytokine release syn-drome and associated neurotoxicity in cancer immunotherapy[J]. Nat Rev Immunol, 2022, 22(2):85-96. |
| [7] | 汤芳, 朱霞明, 陆茵, 等. 多发性骨髓瘤患者行嵌合抗原受体修饰T细胞治疗的护理[J]. 中华护理杂志, 2019, 54(10):1495-1498. |
| Tang F, Zhu XM, Lu Y, et al. Nursing care for patients with multiple myeloma undergoing chimeric antigen receptor T-cell therapy[J]. Chin J Nurs, 2019, 54(10):1495-1498. | |
| [8] | 刘嘉龙, 郭文超, 滕娇, 等. 成人急性肾损伤患者连续性肾脏替代治疗管理的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(2):172-180. |
| Liu JL, Guo WC, Teng J, et al. Summary of best evidence on the management of continuous renal replacement therapy in adult patients with acute kidney injury[J]. Chin J Crit Care Nurs, 2024, 5(2):172-180. | |
| [9] | 中国研究型医院学会生物治疗学专委会. CAR T细胞治疗NHL毒副作用临床管理专家共识[J]. 转化医学杂志, 2021, 10(1):1-11. |
| Biotherapeutics Committee of Chinese Research Hospital Asso-ciation. Experts consensus on clinical management of toxicity associated with CAR T cell therapy in non-Hodgkin’s lympho-ma(NHL)[J]. Transl Med J, 2021, 10(1):1-11. | |
| [10] | 花京剩, 张剑, 陈苏宁, 等. CAR-T细胞技术在复发或难治急性淋巴细胞白血病中的临床应用进展[J]. 临床血液学杂志, 2020, 33(1):78-82. |
| Hua JS, Zhang J, Chen SN, et al. Advances in clinical appli-cation of CAR-T cell technique in relapsed or refractory acute lymphoblastic leukemia[J]. J Clin Hematol, 2020, 33(1):78-82. |
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