Indications for CAR-T cell therapy and management of the complications: an update

Indications for CAR-T cell therapy and management of the complications: an update. Introduction. The engineering of T lymphocytes with the chimeric antigen receptor (CAR-T) opened a new pattern for the treatment of malignant neoplasms and it was pivotal for the treatment of some haematological malignancies. Aim. To describe the therapy with CAR-T, the mechanism, the management process, the role of the multidisciplinary team and high-light the main complications and management, follow-up, the impact on quality of life and the role of nurse. Method. A literature review was conducted. Secondary studies published between 1 January and 17 October 2022, in English and Italian language, on adult population undergoing CAR-T, were included. Of the 335 articles, 64 were, finally, in-cluded. Results. New CAR-T products have been tested for the treatment of acute myeloid leukaemia, multiple myelo-ma and some kind of solid tumours. The two main toxici-ties are the cytokine release syndrome and the neurotoxi-city. Alternative drugs have been tested for minor adverse effects. The multidisciplinary team and the nurse are fun-damental, both in the clinical care and in the organization; an emphasis was put on the correct patients' information. Quality of life after CAR-T treatment is still poorly inves-tigated. Conclusions. The knowledge on CAR-T is in continuous and rapid growth and several questions are still without answer, requiring a continuous update of the transplant centres.