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勇敢新世界:新技术拓展干细胞移植和先进疗法的家庭护理。

Brave new world: expanding home care in stem cell transplantation and advanced therapies with new technologies.

机构信息

Transfusion Section, Hematology Department, University Hospital "Marques de Valdecilla", Santander, Spain.

Home Hospitalization Department, University Hospital "Marques de Valdecilla" - Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain.

出版信息

Front Immunol. 2024 Apr 26;15:1366962. doi: 10.3389/fimmu.2024.1366962. eCollection 2024.

Abstract

Hematopoietic stem cell transplantation and cell therapies like CAR-T are costly, complex therapeutic procedures. Outpatient models, including at-home transplantation, have been developed, resulting in similar survival results, reduced costs, and increased patient satisfaction. The complexity and safety of the process can be addressed with various emerging technologies (artificial intelligence, wearable sensors, point-of-care analytical devices, drones, virtual assistants) that allow continuous patient monitoring and improved decision-making processes. Patients, caregivers, and staff can also benefit from improved training with simulation or virtual reality. However, many technical, operational, and above all, ethical concerns need to be addressed. Finally, outpatient or at-home hematopoietic transplantation or CAR-T therapy creates a different, integrated operative system that must be planned, designed, and carefully adapted to the patient's characteristics and distance from the hospital. Patients, clinicians, and their clinical environments can benefit from technically improved at-home transplantation.

摘要

造血干细胞移植和嵌合抗原受体 T 细胞(CAR-T)等细胞疗法是昂贵且复杂的治疗方法。已经开发出门诊模式,包括居家移植,其结果是生存率相似、成本降低和患者满意度提高。通过各种新兴技术(人工智能、可穿戴传感器、即时分析设备、无人机、虚拟助手)可以解决该过程的复杂性和安全性问题,这些技术允许对患者进行持续监测并改进决策过程。患者、护理人员和工作人员也可以从模拟或虚拟现实的改进培训中受益。然而,需要解决许多技术、操作和最重要的伦理问题。最后,门诊或居家造血干细胞移植或 CAR-T 治疗创建了一个不同的、集成的操作系统,必须对其进行规划、设计并根据患者的特点和与医院的距离进行仔细调整。技术改进的居家移植可以使患者、临床医生及其临床环境受益。

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