Continuing education needs of nurses caring for patients undergoing CAR T-cell therapy for hematological malignancies: A Canadian survey

Ines Ben Henda, Caroline Arbour, Karine Bilodeau

Abstract


CAR T-cell therapy represents a major, ongoing advance in the treatment of hematological malignancies, but it requires complex, highly specialized care. Given the central role they play in managing this care, nurses need access to tailored continuing education. Unfortunately, little evidence exists to guide the development of these programs. This study presents the findings of the first Canadian survey designed to identify the continuing education needs of nurses involved in the care of adult patients receiving CAR T-cell therapy.

A bilingual (French and English) survey developed using the competency framework proposed by He et al. (2024) and adapted to the Canadian context was sent to the members of the Canadian Association of Nurses in Oncology/Association canadienne des infirmières en oncologie (CANO/ACIO). The resulting data were analyzed using descriptive statistics and qualitative thematic analysis. 

A total of 88 nurses completed the questionnaire. Most were women (94%), aged 30 to 49 years (73%), working primarily in oncology (38%), or an outpatient centre (35%). The findings revealed significant needs in terms of theoretical knowledge (treatment processes, complications) and operational skills (therapy administration, management of side effects, outpatient follow-up, interdisciplinary communication). Notable differences were observed depending on practice setting, clinical experience and prior training. 

These findings emphasize the need to develop structured continuing education programs that are easy to access and adapted to suit various practice settings in order to support nurses in delivering safe, high-quality care to patients undergoing CAR T-cell therapy.

Keywords: training needs, nursing care, continuing education, CAR T-cell therapy, hematological malignancies, survey, Canada

https://doi.org/10.5737/23688076363365


Full Text:

PDF

References


Alencar, M. C. (2019). CAR T-cell therapy for large B-cell lymphoma. Journal of the advanced Practitioner in Oncology, 10(Suppl 3), 5–9. https://doi.org/10.6004/jadpro.2019.10.4.9

Baer, B. (2021). CAR T-cell therapy : Updates in nursing management. Clinical Journal of Oncology Nursing, 25(3), 255–258. https://doi.org/10.1188/21.Cjon.255-258

Buechner, J., Kersten, M. J., Fuchs, M., Salmon, F., & Jäger, U. (2019). Chimeric antigen receptor-T cell therapy: Practical considerations for implementation in Europe. HemaSphere, 2(1), e18. https://doi.org/10.1097/HS9.0000000000000018

Canadian Cancer Society/Société canadienne du cancer. (2024). Canadian cancer statistics. https://cancer.ca/en/research/cancer-statistics/canadian-cancer-statistics

Clout, R., Murray, J., Farrell, M., Hutt, D., & Kenyon, M. (2023). Cell therapy nursing implications and care. In, M. Kenyon & A. Babic (Eds.), The European Blood and Marrow Transplantation Textbook for Nurses: Under the Auspices of EBMT (p. 101–122). Springer International Publishing. https://doi.org/10.1007/978-3-031-23394-4_7

Cunningham, K., DiFilippo, H., Henes, K., Irwin, L. L., Napier, E., & Weber, E. (2021). Tisagenlecleucel therapy: Nursing considerations for the outpatient setting. Seminars in Oncology Nursing, 37(4), 151178. https://doi.org/10.1016/j.soncn.2021.151178

Dai, Y., Tang, F., Mao, Y., He, N., Yu, M., Zhang, M., Gu, S., Lu, Y., Shang, J., & Zhu, X. (2023). Nursing care of patients with relapsed and refractory multiple myeloma treated with B-cell mature antigen-targeted universal chimeric antigen receptor T cells. Medicine, 102(47), e36067. https://doi.org/10.1097/MD.0000000000036067

Ellard, R., & Verity, R. (2019). CAR-T nursing education at a UK specialist cancer hospital. Annals of Oncology, 30(Suppl 5), v848. https://doi.org/10.1093/annonc/mdz277.009

Eysenbach, G. (2004). Improving the quality of web surveys : The checklist for reporting results of interned e-surveys (CHERRIES). Journal of Medical Internet Research, 6(3), e34. https://doi.org/10.2196/jmir.6.3.e34

Frey, N., & Porter, D. (2019). Cytokine release syndrome with chimeric antigen receptor T cell therapy. Biology of Blood and Marrow Transplantation, 25(4), 3123–e127. https://doi.org/10/1016/j.bbmt.2018.12.756

Galassi, A., Anwarali, S., & Challinor, J. (2023). Global challenges and initiatives in oncology nursing education. Annals of Palliative Medicine, 12(3), 633–645. https://doi.org/10.21037/apm-22-1120

Gauthier, J. & Yakoub-Agha, I. (2017). Chimeric antigen-receptor T-cell therapy for hematological malignancies and solid tumors: Clinical data to date, current limitations and perspectives. Current Research in Translational Medicine, 65(3), 93–102. https://doi.org/10.1016/j.retram.2017.08.003

Gregory, S. (2019). Adult acute lymphoblastic leukemia: Treatment and management updates. Seminars in Oncology Nursing, 35(6), 150951. https://doi.org/10.1016/j.soncn.2019.150951

Gupta, A., Dagar, G., Rehmani, M. U., Prasad, C. P., Saini, D., Singh, M. & Shankar, A. (2024). CAR T-cell therapy in cancer: Integrating nursing perspectives for enhanced patient care. Asia-Pacific Journal of Oncology Nursing, 11(10). https://doi.org/10.1016/j.apjon.2024.100579

Hankewycz, M. (2019). Evaluating nursing readiness and competency for direct patient cae after initiation of new pediatric CAR-T cell therapy program. Biology of Blood and Marrow Transplantation, 25(Supp 3), S82–S83. https://doi.org/10.1016/j.bbmt.2018.12.188

Hayden, P. J., Roddie, C., Bader, P., Basak, G. W., Bonig, H., Bonini, C., Chabannon, C., Ciceri, F., Corbacioglu, S., Ellard, R., Sanchez-Guijo, F., Jäger, U., Hildebrandt, M., Hudecek, M., Kersten, M. J., Köhl, U., Kuball, J., Mielke, S., Mohty, M., Murray, J., … Yakoub-Agha, I. (2022). Management of adults and children receiving CAR T-cell therapy: 2021 best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association (EHA). Annals of Oncology: Official Journal of the European Society for Medical Oncology, 33(3), 259–275. https://doi.org/10.1016/j.annonc.2021.12.003

He, J., Li, J., Feng, L. M., Feng, L. X., qiang, W., Wang, W., & Dong, L. (2024). Oncology nurse competency in chimeric antigen receptor T-cell therapy: A qualitative study. Nurse Education Today, 132, 106040, https://doi.org/10.1016/j.nedt.2023.106040

Jackson S., & Wheatley, T. (2021). Chimeric antigen receptor T-cell emergencies: Inpatient administration, assessment, and management. Seminars in Oncology Nursing, 37(2), 151134. https://doi.org/10.1016/j.soncn.2021.151134

Jezequel, T., Ajazi Hub, R., Bompoint, C., Chauvel, C., Colonnese, E., Corbineau, C., Desmedg, C., Kicki, C., Lomazzi, S. Sirvent, A., Evard, S., Roux, K., Magro, L., & Colledani, F. (2025). Compétences cliniques et transversales des infirmier(e)s en pratique avancée (IPA) au sein d’une équipe de thérapie cellulaire (SFGM-TC) [Clinical and transversal competencies of advanced practice nurses (APNs) within a cellular therapy team (SFGM-TC)]. Bulletin du cancer, 112(1S), S92–S102. https://doi.org/10.1016/j.bulcan.2024.06.002

Kisielewski, D., & Naegele, M. (2024). Advanced practice nursing and CAR-T cell therapy: Opportunities, challenges and future directions. Seminars in Oncology Nursing, 40(3), 151628. https://doi.org/10.1016/j.soncn.2024.151628

Knox, A. (2020. Optimisation du rôle de l’infirmière spécialisée en oncologie dans l’unité de soins ambulatoires. Canadian Oncology Nursing Journal, 30(3), 169–179. https://doi.org/10.5737/23688076303169179

Labesse, M. E., & Farley, C. (2008). Cadre de référence sur l’analyse de besoins de formation : volet formation continue. Institut national de santé publique de Québec. https://222.inspq.qc.ca/sites/default/files/publications/800_cadre_de_reference.pdf

Lamprecht, M., & Dansereau, C. (2019). CAR T-cell therapy: Update on the state of the science. Clinical Journal of Oncology Nursing, 23, 6–12. https://doi.org/10.1188/19.CJON.S1.6-12

Lanier, O. L., Pérez-Herrero, E., Andrea, A. P. D., Bahrami, K., Lee, E., Ward, D. M., Ayala-Suárez, N., Rodríguez-Méndez, S. M., & Peppas, N. A. (2022). Immunotherapy approaches for hematological cancers. iScience, 25(11). https://doi.org/10.1016/j.isci.2022.105326

Leinemann, V., & Krutter, S. (2024). ‘The last bridge’–How patients experience the CAR T-cell therapy. A qualitative study. European Journal of Oncology Nursing, 68, 102494. https://doi.org/10.1016/j.ejon.2023.102494

Liptrott, S., NíChonghaile, M., & Aerts, E. (2019). Investigating the self-perceived educational priorities of haematology nurses. European Journal of Oncology Nursing, 41, 72–81. https://doi.org/10.1016/j.ejon.2019.05.010

Murphy, M., Fromentin, M., Campeau, J., Sebag, M., Couture, F., Larouche, J.-F., Lemieux, C., Lachance, S., Cohen, S., Mollica, L., Veilleux, O., & Fleury, I. (2022). Geographical CAR-T unmet needs for patients with large B-cell lymphoma in the Province of Quebec. Blood, 140(Suppl 1), 13228–13229. https://doi.org/10.1182/blood-2022-156473

Nakagaki, M., Gavin, N. C., Hayes, T., Fichera, R., Stewart, C., Naumann, L., Brennan, J., Perry, N., Foley, E., Crofton, E., Brown, C., Leutenegger, J., & Kennedy, G. A. (2022). Implementation and evaluation of a nurse-allied health clinic for patients after haematopoietic stem cell transplantation. Supportive Care in Cancer, 30(1), 647–657. https://doi.org/10.1007/s00520-021-06461-w

Paillé, P., & Mucchielli, A. (2016). L’analyse qualitative en sciences humaines et sociales. Armand Colin. https://doi.org/10.3917/arco.paill.2016.01

Sochacka-?wik?a, A., M?czy?ski, M., & Regiec, A. (2021). FDA-approved drugs for hematological malignancies—The last decade review. Cancers, 14(1), 87. https://doi.org/10.3390/cancers14010087

Steinbach, M., Zitella, L. J., Florendo, E., Lee, E., Riccobono, C., DiFilippo, H., & Aronson, E. (2023). Nursing care throughout the chimeric antigen receptor T-cell therapy process for multiple myeloma. Seminars in Oncology Nursing, 39(6), 151505. https://doi.org/10.1016/j.soncn.2023.151505

Szenes, V., & Curran, K. J. (2019). Utilization of CAR T cell therapy in pediatric patients. Seminars in Oncology Nursing, 35(5), 150929. https://doi.org/10.1016/j.soncn.2019.08.008

Tan, X. X. S., Maltez, M., Mallick, R., Hamelin, L., McDiarmid, C., Kennah, M., Atkins, H., & Kekre, N. K. (2023) CAR-T therapy for the treatment of relapsed/refractory CD19 positive large B cell lymphoma: Canadian real-world evidence. Blood, 142(Suppl 1), 6923–6923. https://doi.org/10.1182/blood-2023-179044

Taylor, L., Rodriguez, E. S., Reese, A., & Anderson, K. (2019). Building a program: Implications for infrastructure, nursing education, and training for CAR T-cell therapy. Clinical Journal of Oncology Nursing, 23(2), 20–26. https://doi.org/10.1188/19.CJON.S1.20-26


Refbacks

  • There are currently no refbacks.