Pediatric acute lymphoblastic leukemia (ALL) is the most common childhood cancer. There have been significant improvements in pediatric ALL survival rates over the past 50-60 years. Unfortunately, approximately 15% of patients relapse and cure rates are much lower after relapse. Many of these patients require newer, more novel therapies and targeted immunotherapy using anti-CD19 chimeric antigen receptor T cells (CAR T) is one of those therapies. A patient’s own T cells are collected and then genetically engineered to recognize and attack CD19 + tumors. Benefits of CAR T cell therapy include expansion of the CAR T cells in the patient and potential for long-term persistence for disease surveillance. This therapy has shown encouraging results in patients with refractory and relapsed ALL. With therapies like this becoming more widely available, pediatric oncology nurses will need to understand the concept of these therapies and know the risks and side effects in order to provide care to these patients. Nurses play an important role in providing safe care and patient management. They are often the first clinicians to recognize side effects and problems. There is also a significant role for nurses in providing anticipatory guidance and education for patients and their families.
Colleen Callahan, RN, MSN, CRNP
Nurse Practitioner, Division of Oncology
Children’s Hospital of Philadelphia
Colleen Callahan, MSN, CRNP, has worked in pediatric oncology for 23 years, 18 of which as a nurse practitioner in the Oncology Division at Children’s Hospital of Philadelphia. She has worked in the Cancer Immunotherapy Program for the past five years caring for patients pre, during, and post CAR T-cell therapy in the outpatient setting. She follows these patients from their initial referral to the cancer immunotherapy team, through their T cell collection, T cell infusion, and then after infusion monitoring for side effects, adverse events, and long-term effects and responses.