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造血细胞移植和嵌合抗原受体T细胞疗法中的远程医疗

Telemedicine in Hematopoietic Cell Transplantation and Chimeric Antigen Receptor-T Cell Therapy.

作者信息

Gandhi Arpita P, Lee Catherine J

机构信息

Center for Hematologic Malignancies, Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA.

Fred Hutch Cancer Research Center, Clinical Research Division, Seattle, WA 98109, USA.

出版信息

Cancers (Basel). 2023 Aug 15;15(16):4108. doi: 10.3390/cancers15164108.

Abstract

Telemedicine has played an important role in delivering healthcare for primary care, chronic disease patients, and those with solid organ malignancies. However, its application in subspecialties such as hematologic malignancies, hematopoietic cell transplantation (HCT), or chimeric antigen receptor-T cell (CAR-T) therapy is not widespread since physical examination is a vital component in delivering care. During the COVID-19 pandemic, we widely used telemedicine, since protecting our immunocompromised patients became our top priority. The employment of HCT and CAR-T therapies continues to grow for high-risk hematologic malignancies, particularly in older and frail patients who must visit specialty centers for treatment access. Generally, HCT and CAR-T therapy care is highly complex, necessitating commitment from patients, caregivers, and a multidisciplinary team at specialty academic centers. All healthcare systems adapted to the crisis and implemented rapid changes during the COVID-19 public health emergency (PHE). Telemedicine, a vital modality for delivering healthcare in underserved areas, experienced rapid expansion, regardless of the geographic region, during the COVID-19 PHE. The data emerging from practices implemented during the PHE are propelling the field of telemedicine forward, particularly for specialties with complex medical treatments such as HCT and CAR-T therapy. In this review, we examine the current data on telemedicine in HCT and cellular therapy care models for the acute and long-term care of our patients.

摘要

远程医疗在为初级保健、慢性病患者以及实体器官恶性肿瘤患者提供医疗服务方面发挥了重要作用。然而,由于体格检查是提供医疗服务的重要组成部分,其在血液系统恶性肿瘤、造血细胞移植(HCT)或嵌合抗原受体T细胞(CAR-T)治疗等亚专业领域的应用并不广泛。在新冠疫情期间,我们广泛使用了远程医疗,因为保护免疫功能低下的患者成为了我们的首要任务。对于高危血液系统恶性肿瘤,尤其是那些必须前往专科中心接受治疗的老年体弱患者,HCT和CAR-T疗法的应用持续增加。一般来说,HCT和CAR-T治疗护理非常复杂,需要患者、护理人员以及专科学术中心的多学科团队共同努力。在新冠公共卫生紧急事件(PHE)期间,所有医疗系统都适应了危机并迅速做出了改变。远程医疗作为在服务不足地区提供医疗服务的重要方式,在新冠PHE期间,无论地理区域如何,都经历了快速扩张。PHE期间实施的实践所产生的数据正在推动远程医疗领域向前发展,特别是对于HCT和CAR-T治疗等具有复杂医疗手段的专科领域。在本综述中,我们研究了关于远程医疗在HCT以及我们患者的急性和长期护理细胞治疗护理模式方面的当前数据。

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