Withycombe Janice S, Kubaney Holly R, Okada Maki, Yun Christine S, Gupta Sumit, Bloom Caylie, Parker Veronica, Rau Rachel E, Zupanec Sue
Author Affiliations: Clemson University, Clemson (Dr Withycombe, Ms Bloom, and Dr Parker); and Prisma Health Children's Hospital, Greenville (Dr Withycombe), South Carolina; Dell Children's Blood and Cancer Center, Austin, Texas (Mrs Kubaney); Miller Children's & Women's Hospital, Long Beach, California (Mrs Okada); and Children's Hospital of Orange County, Orange (Mrs Yun), California; Texas Children's Hospital, Houston (Dr Rau), and SickKids, Toronto, Ontario, Canada (Dr Gupta and Mrs Zupanec).
Cancer Nurs. 2024;47(6):451-459. doi: 10.1097/NCC.0000000000001309. Epub 2023 Nov 22.
Blinatumomab is an immunotherapy agent used in pediatric oncology for the treatment of B-lineage acute lymphoblastic leukemia. Administration of blinatumomab, via continuous 28-day infusion cycles, can present multiple decision points and challenges related to patient care. Nurses are at the forefront of coordinating and delivering care for patients receiving blinatumomab.
To describe the current state of practice across Children's Oncology Group (COG) member institutions regarding blinatumomab administration in both inpatient and home/outpatient settings.
Between August and December 2021, a cross-sectional survey was used to determine current institutional practices related to blinatumomab administration. A single targeted respondent who was actively engaged in coordinating blinatumomab administration completed the survey on behalf of each COG institution.
Survey participation rate was 78% (150/192). During the first 28-day blinatumomab cycle, 71 institutions (53%) reported patient hospital stays between 73 hours and 7 days; 42 (31%) reported hospital stays ≤72 hours, and only 12 (9%) reported hospitalization for the full 28-day infusion. Small- to medium-size institutions were more likely to report longer hospitalizations ( P = .03). Most blinatumomab administration occurred in the outpatient setting, with low rates of unplanned clinic/emergency room visits.
The majority of COG institutions have navigated the complex coordination of care required for children to receive blinatumomab at home. Wide variations in practice were noted across institutions.
This study describes current institutional practices surrounding administration of 28-day blinatumomab infusions in children with leukemia and offers a starting point for institutional benchmarking and standardization of practice.
博纳吐单抗是一种免疫治疗药物，用于儿科肿瘤学中治疗B系急性淋巴细胞白血病。通过连续28天的输注周期给药博纳吐单抗，会出现多个与患者护理相关的决策点和挑战。护士处于协调和为接受博纳吐单抗治疗的患者提供护理的前沿。
描述儿童肿瘤学组（COG）成员机构在住院和家庭/门诊环境中使用博纳吐单抗的当前实践状况。
在2021年8月至12月期间，采用横断面调查来确定与博纳吐单抗给药相关的当前机构实践。每个COG机构由一名积极参与协调博纳吐单抗给药的单一目标受访者完成调查。
调查参与率为78%（150/192）。在博纳吐单抗的第一个28天周期中，71家机构（53%）报告患者住院时间在73小时至7天之间；42家（31%）报告住院时间≤72小时，只有12家（9%）报告整个28天输注期间均住院。中小型机构更有可能报告较长的住院时间（P = 0.03）。大多数博纳吐单抗给药发生在门诊环境中，计划外门诊/急诊就诊率较低。
大多数COG机构已经应对了儿童在家中接受博纳吐单抗所需的复杂护理协调工作。各机构在实践中存在很大差异。
本研究描述了目前白血病患儿28天博纳吐单抗输注给药的机构实践情况，并为机构基准测试和实践标准化提供了一个起点。
