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用氮芥凝胶优化蕈样肉芽肿性皮肤T细胞淋巴瘤治疗的护理与依从性

Optimizing Care and Compliance for the Treatment of Mycosis Fungoides Cutaneous T-Cell Lymphoma With Mechlorethamine Gel.

作者信息

Benjamin Chase Allister, Markel Kristen, Tawa Marianne C

机构信息

UCLA Medical Center, Santa Monica.

Stanford University.

出版信息

Clin J Oncol Nurs. 2015 Dec;19(6):E131-9. doi: 10.1188/15.CJON.E131-E139.

Abstract

BACKGROUND

Mycosis fungoides is the most common form of cutaneous T-cell lymphoma (MF-CTCL). Quality nursing care is necessary for effective diagnosis and treatment of patients with MF-CTCL. Early-stage MF-CTCL (stages Ia and Ib) is most often managed in both dermatology and multidisciplinary settings. These stages can be effectively controlled by skin-directed therapies such as mechlorethamine gel (Valchlor®). Topical mechlorethamine has been used since the 1940s as an alkylating agent; however, compounded formulas have disadvantages that limit patient compliance. In contrast, newly approved mechlorethamine gel has demonstrated an efficacious and well-tolerated profile that has longer stability and is quicker to dry than its compounded counterpart.

OBJECTIVES

This article aims to provide recommendations for optimal nursing care of patients who have been diagnosed with stage Ia or Ib MF-CTCL.

METHODS

Four real-world patient cases are examined, along with practical considerations for the use of mechlorethamine gel to treat patients with MF-CTCL.

FINDINGS

Nurses can promote patient adherence through specific interventions and strategies, such as education about mechlorethamine gel, its mechanism of action, and safety and efficacy, as well as connecting patients with patient assistance programs or other supportive services.

摘要

背景

蕈样肉芽肿是皮肤T细胞淋巴瘤(MF-CTCL)最常见的形式。优质护理对于MF-CTCL患者的有效诊断和治疗至关重要。早期MF-CTCL(Ia期和Ib期)通常在皮肤科和多学科环境中进行管理。这些阶段可以通过诸如氮芥凝胶(Valchlor®)等皮肤定向疗法得到有效控制。自20世纪40年代以来,外用氮芥一直作为一种烷化剂使用;然而,复方制剂存在一些缺点,限制了患者的依从性。相比之下,新批准的氮芥凝胶已显示出有效且耐受性良好的特点,其稳定性更长,干燥速度比复方制剂更快。

目的

本文旨在为已诊断为Ia期或Ib期MF-CTCL的患者提供最佳护理建议。

方法

研究了4个实际患者案例,以及使用氮芥凝胶治疗MF-CTCL患者的实际注意事项。

结果

护士可以通过特定的干预措施和策略来促进患者的依从性,例如对氮芥凝胶、其作用机制以及安全性和有效性进行教育,以及将患者与患者援助计划或其他支持服务联系起来。

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