The EBMT Immune Effector Cell Nursing Guidelines on CAR-T Therapy: A Framework for Patient Care and Managing Common Toxicities.

Chimeric antigen receptor T-cell (CAR T) therapy is a new and rapidly developing field. Centers across the world are gaining more experience using these innovative anti-cancer treatments, transitioning from the 'bench' to the 'bedside', giving benefit to an increasing number of patients. For those with some refractory hematological malignancies, CAR-T may offer a treatment option that was not available a few years ago.CAR-T therapy is an immune effector cell and precision/personalized medicine treatment which is tailored to the individual patient and associated with a variety of unique adverse events and toxicities that necessitate specialist nursing/medical vigilance in an appropriate clinical setting. Subtle unrecognized signs and symptoms can result in rapid deterioration and, possibly, life threatening cardiorespiratory and/or neurological sequelae.These guidelines have been prepared for nurses working in cellular therapy in inpatient, outpatient and ambulatory settings. Many nurses will encounter cellular therapy recipients indirectly, during the referral process, following discharge, and when patients are repatriated back to local centers. The aim of these guidelines is to provide all nurses with a practice framework to enable recognition, monitoring and grading of CAR-T therapy-associated toxicities, and to support and nurse these highly complex patients with confidence.They have been developed under the auspices of several bodies of the European society for Blood and Marrow Transplantation (EBMT), by experienced health professionals, and will be a valuable resource to all practitioners working in cellular therapy.

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RE: KG: speaker honoraria, travel grant; Novartis: speaker honoraria; Janssen: Advisory board, speaker honoraria, BMS Celgene: Advisory board, speaker honoraria, educational grant. MK: nothing to declare. DH: nothing to declare. EA: nothing to declare. M de R: Takeda: advisory board, Novartis: advisory board, Janssen: advisory board. CC: received honorarium from Gilead, Novartis, Janssen, Celgene (now BMS), Sanofi SA, Bellicum, Terumo BCT and research support from Sanofi SA, Miltenyi Biotec, Fresenius Kabi. MM: nothing to declare. SM: nothing to declare. EW: Jazz: speaker honoraria. John Murray: Kite/Gliead: speaker honoraria, Jazz: speaker honoraria and Therakos: speaker honoraria.