MacDonald David, Puckrin Robert, Skrabek Pamela, Lam Selay, Jayakar Jai, Fleury Isabelle, Lemieux Christopher, Boutin Mélina, Costello Jacqueline
Division of Hematology, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada.
Arthur J.E. Child Comprehensive Cancer Centre, Calgary, AB T2N 5G2, Canada.
Curr Oncol. 2025 Aug 15;32(8):460. doi: 10.3390/curroncol32080460.
(1) Background: Bispecific antibodies (BsAbs) for the treatment of relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) can be delivered in ambulatory healthcare settings; however, the safe and effective management of potential side effects, such as cytokine release syndrome (CRS), requires protocolized monitoring and management. (2) Methods: An Expert Working Group (EWG) of nine hematologists from across Canada, with experience in leading BsAb program implementation, combined a review of published literature, a comparison of national/provincial/regional guidance documents and protocols, and their professional experiences to produce an informed framework for BsAb program implementation in various healthcare settings. (3) Results: The EWG supports and recommends the progression of BsAb provision from predominantly inpatient hospital settings to community/ambulatory care settings closer to the patient's home. A seven-step implementation process is outlined to support the safe and effective establishment of such programs, from establishing leadership, through customization of protocols, to education and execution. Strategies and considerations are offered to overcome potential barriers and empower healthcare professionals who are working to establish or improve BsAb programs across Canada. (4) Conclusions: For patients with R/R DLBCL, the safe and effective provision of BsAbs closer to home is both feasible and preferred. This guidance is intended to support the efficient and effective setup or enhancement of BsAb programs in lymphoma.
（1）背景：用于治疗复发/难治性弥漫性大B细胞淋巴瘤（R/R DLBCL）的双特异性抗体（BsAb）可在门诊医疗环境中给药；然而，对细胞因子释放综合征（CRS）等潜在副作用进行安全有效的管理需要规范化的监测和管理。（2）方法：由来自加拿大各地的九位血液学家组成的专家工作组（EWG），他们在领导BsAb项目实施方面具有经验，结合了对已发表文献的回顾、对国家/省/地区指导文件和方案的比较以及他们的专业经验，以制定一个在各种医疗环境中实施BsAb项目的明智框架。（3）结果：EWG支持并建议将BsAb的供应从主要的住院医院环境推进到更靠近患者家庭的社区/门诊护理环境。概述了一个七步实施过程，以支持此类项目的安全有效建立，从建立领导机构，到定制方案，再到教育和执行。提供了策略和注意事项，以克服潜在障碍，并使致力于在加拿大各地建立或改进BsAb项目的医疗专业人员具备能力。（4）结论：对于R/R DLBCL患者，在离家更近的地方安全有效地提供BsAb既可行又更可取。本指南旨在支持淋巴瘤BsAb项目的高效有效设立或加强。
