Nilsen L, Santos BND, Leopoldo VC, Reis PEDD, Oliveira MCD, Clark AM, Silveira RCDCP. Nursing interventions in autologous stem cell transplantation for autoimmune diseases.
J Adv Nurs 2020;
76:3473-3482. [PMID:
32989824 DOI:
10.1111/jan.14559]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/16/2020] [Accepted: 08/10/2020] [Indexed: 11/27/2022]
Abstract
AIMS
To identify clinical symptoms and nursing interventions for stem cell therapy in autoimmune diseases.
DESIGN
This is a retrospective, cross-sectional study.
METHODS
This study was undertaken with patients diagnosed with type 1 diabetes or multiple sclerosis, undergoing autologous haematopoietic stem cell transplantation from January 2004 - December 2018. Data were registered in a questionnaire, taken during the conditioning regimen comprising cyclophosphamide and rabbit anti-thymocyte globulin. Descriptive statistics and Fisher's exact test were used for data analysis.
RESULTS
There were 68 and 23 patients in the multiple sclerosis and type 1 diabetes groups respectively. Skin rash, nausea, vomiting and fever were more frequent and diverse in the type 1 diabetes group. Steroids were used as prophylaxis for anti-thymocyte globulin-associated allergic reactions in 97% of multiple sclerosis patients. Most of the identified symptoms and nursing interventions were more associated with one or other disease group (p < .05) and were more frequent in the type 1 diabetes group.
CONCLUSION
Patients with autoimmune diseases who underwent stem cell therapy present differences in their repertoire of adverse events and require disease-specific nursing actions.
IMPACT
Our results may enable nurses to establish transplant and disease-specific guidelines to improve prevention and management of adverse events and therefore optimize patient care and therapeutic success.
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