Nursing management for ICANS of CAR T-cell therapy in B cell acute lymphoblastic leukemia ^†

Abstract Objective Immune effector cell-associated neurotoxic syndrome (ICANS) is one of the most concerning complications because of its life-threatening trait during chimeric antigen receptor (CAR) T-cell therapy and requires specialized management. We summarized the nursing procedures of CAR T-cell therapy for ICANS to provide some references for the standardized nursing care of ICANS. Methods Based on previous experience and literature research, the professional team developed nursing procedures for ICANS for patients receiving CAR T-cell therapy. Results The professional team developed step-by-step, sophisticated care procedures before, during, and after ICANS, including active communication and collaboration, knowledge updates, personalized nursing plans, advanced assessments, close monitoring of vital signs and laboratory tests, medication plans, timely and correct drug administration, dietary nursing interventions, safety care, nursing of other complications, follow-up of toxicities, and keeping an eye on the potential side effects. Conclusions ICANS is unique, with varying clinical symptoms and rapid progression. Timely and accurate treatment and care of patients is an effective way to manage ICANS. Professional and detailed procedures are required to guide nurses to manage patients’ ICANS, so as to improve the safety of patients and the promotion of CAR T-cell therapy