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Addressing Administration Challenges Associated With Blinatumomab Infusions: A Multidisciplinary Approach.
Stephanie Szoch1, Christina Boord, Alison Duffy
1University of Maryland Medical Center, Baltimore, Maryland. Stephanie Szoch, BSN, RN, OCN®, is a senior clinical nurse II at the University of Maryland Medical Center (UMMC). She chairs the cancer center's Clinical Practice Council and has participated in transitioning vincristine infusions to minibags at UMMC, as well as in other process improvement initiatives to reduce chemotherapy errors. Christina Boord, BSN, RN, OCN®, is a clinical practice and education specialist at UMMC. She sits on several hospital- and system-wide committees working to improve patient-centered care. She is passionate about supporting staff in education and process improvement initiatives to reduce chemotherapy errors. Alison Duffy, PharmD, BCOP, is a clinical specialist in hematology/oncology at UMMC. Dr Duffy is a clinical assistant professor at the University of Maryland School of Pharmacy, as well as the medication safety cochair for the Maryland Society of Health-System Pharmacy. Her interests are in clinical outcomes and practice-based research specifically related to immunocompromised hosts and patients with hematologic malignancies, as well as oncology-related medication safety. Ciera Patzke, PharmD, is a pharmacy resident practicing at UMMC, where she is completing a postgraduate year 2 oncology pharmacy residency through the University of Maryland School of Pharmacy.
Blinatumomab shows promise for B-cell acute lymphocytic leukemia. Early detection of neurological side effects is crucial for treatment success, necessitating standardized nursing assessments and administration guidelines.
Area of Science:
- Oncology
- Hematology
- Pharmacology
Background:
- Blinatumomab is a bispecific antibody effective against B-cell acute lymphocytic leukemia (B-ALL).
- Chemotherapy-resistant B-ALL presents a significant treatment challenge.
- Blinatumomab treatment is associated with specific toxicities, including central nervous system (CNS) events and cytokine release syndrome (CRS).
Purpose of the Study:
- To outline guidelines for the safe preparation and administration of blinatumomab.
- To introduce a standardized neurological nursing assessment for early toxicity detection.
- To ensure patients can complete their full blinatumomab treatment course.
Main Methods:
- Development of standardized guidelines for blinatumomab preparation and administration in inpatient and outpatient settings.
- Implementation of a structured neurological nursing assessment protocol.
- Review of existing literature and expert consensus on blinatumomab-related toxicities.
Main Results:
- Established guidelines facilitate safe blinatumomab administration.
- Standardized neurological assessments enable early identification of CNS toxicities.
- Proactive management strategies improve treatment adherence and outcomes.
Conclusions:
- Blinatumomab is a valuable therapeutic option for refractory B-ALL.
- Early detection and management of neurological toxicities are essential for successful blinatumomab therapy.
- Standardized protocols enhance patient safety and treatment efficacy.
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