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Creación de Estándares de Administración de Blinatumomab: Experiencia de una Sola Institución
Sue Zupanec1, Lisa Honeyford1, Allison Starr1
1Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
Pediatric blood & cancer
|January 22, 2026
Resumen
Los protocolos estandarizados de administración de blinatumomab mejoraron la seguridad y la eficiencia en la atención de la leucemia linfoblástica aguda B (LLA-B) pediátrica. Esta iniciativa de mejora de la calidad redujo el uso de antibióticos y la variabilidad en la práctica, mejorando la experiencia del paciente.
Área de la Ciencia:
- Oncología Pediátrica; Hematología; Ciencia de la Mejora de la Calidad
Sus antecedentes:
- Blinatumomab es un tratamiento vital para la leucemia linfoblástica aguda B (LLA-B) pediátrica.; Su administración presenta desafíos operativos, incluida la infusión continua y las toxicidades únicas.; Se necesitan protocolos estandarizados para optimizar la seguridad, la eficiencia y la experiencia del paciente.
Objetivo del estudio:
- Desarrollar, implementar y evaluar un protocolo institucional estandarizado para la administración de blinatumomab.; Abordar los desafíos operativos y las toxicidades únicas asociadas con la terapia de blinatumomab.; Optimizar la seguridad, la eficiencia y la experiencia del paciente durante el tratamiento con blinatumomab.
Principales métodos:
- Un Grupo de Trabajo Multidisciplinario sobre Blinatumomab desarrolló estándares armonizados en cinco dominios: educación del cuidador, manejo de la fiebre, evaluaciones de enfermería, manejo de interrupciones de la infusión y uso de bolsas de infusión de 7 días.; Se llevó a cabo una iniciativa de mejora de la calidad en The Hospital for Sick Children, Toronto, Canadá.; Se analizaron datos de 53 pacientes que recibieron blinatumomab entre julio de 2024 y agosto de 2025.
Principales resultados:
- El 100% de los cuidadores elegibles completaron la educación estandarizada.; El uso empírico de antibióticos durante la iniciación de blinatumomab disminuyó del 68% al 22% sin eventos adversos.; Las tasas de finalización de la evaluación de enfermería fueron altas (95% pacientes hospitalizados, 81% pacientes ambulatorios) y las interrupciones de la infusión se manejaron de manera segura.
Conclusiones:
- Los protocolos multidisciplinarios y estandarizados de administración de blinatumomab son factibles y seguros.; Estos protocolos mejoraron la administración de antibióticos, empoderaron la atención dirigida por enfermería y redujeron la variabilidad en la práctica.; Este marco puede informar las mejores prácticas para la administración de blinatumomab en centros de oncología pediátrica.
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