Dai Hongyuan, Xu Shuya, Wang Zengxiang, Li Zhenyu, Cao Jiang, Hu Tingyu, Zhou Fang
Department of Nursing, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
School of Nursing, Xuzhou Medical University, Jiangsu, China.
Sci Rep. 2025 May 22;15(1):17763. doi: 10.1038/s41598-025-02720-6.
Few studies have thoroughly evaluated the symptom burden and quality of life (QOL) among patients diagnosed with hematologic malignancies who underwent chimeric antigen receptor T-cell (CAR-T) therapy. In total, 97 eligible patients completed the Functional Assessment of Cancer Therapy generic scale (FACT-G) at week 4 after CAR-T cell infusion. We used the Common Terminology Criteria Adverse Events (CTCAE) to measure symptom burden of CAR-T patients during the same period. We studied factors associated with QOL using liner regression analysis. During the period of hospitalization after CAR-T treatment, the prevalence of self-reported symptoms among CAR-T patients was highest for fatigue (89.7%), followed by sleep disorders (79.4%) and decreased appetite (66.0%). And the mean score of FACT-G was 69.06 (SD = 13.88). Liner regression analysis showed that decreased appetite (β = -0.30, 95% CI = -7.48 to -1.83, P = 0.002), fatigue (β = -0.28, 95% CI = -7.23- -1.69, P = 0.002), nausea (β = -0.26, 95% CI = -10.50 to -2.16, P = 0.003) and a history of hematopoietic stem cell transplantation (HSCT) (β = -0.21, 95% CI = -13.38- -1.56, P = 0.014) were associated with poorer quality of life. The symptom burden experienced by patients undergoing CAR-T treatment is substantial during their hospitalization, and it is closely associated with a diminished quality of life. It is imperative for clinical medical staff to be attentive to the symptom burden of CAR-T patients and to enhance the effectiveness of symptom management interventions.
很少有研究全面评估接受嵌合抗原受体T细胞(CAR-T)治疗的血液系统恶性肿瘤患者的症状负担和生活质量(QOL)。共有97名符合条件的患者在CAR-T细胞输注后第4周完成了癌症治疗功能评估通用量表(FACT-G)。我们使用常见不良反应术语标准(CTCAE)来衡量同期CAR-T患者的症状负担。我们使用线性回归分析研究与生活质量相关的因素。在CAR-T治疗后的住院期间,CAR-T患者自我报告症状的发生率最高的是疲劳(89.7%),其次是睡眠障碍(79.4%)和食欲下降(66.0%)。FACT-G的平均得分为69.06(标准差=13.88)。线性回归分析表明,食欲下降(β=-0.30,95%置信区间=-7.48至-1.83,P=0.002)、疲劳(β=-0.28,95%置信区间=-7.23至-1.69,P=0.002)、恶心(β=-0.26,95%置信区间=-10.50至-2.16,P=0.003)和造血干细胞移植(HSCT)史(β=-0.21,95%置信区间=-13.38至-1.56,P=0.014)与较差的生活质量相关。接受CAR-T治疗的患者在住院期间经历的症状负担较重,且与生活质量下降密切相关。临床医务人员必须关注CAR-T患者的症状负担,并提高症状管理干预措施的有效性。