Oncology Nursing Society Congress

SOP for Successful Administration of Immune Effector Cell Therapy

Avatar photoJoyce Pagan
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Patients and doctor in infusion room
An SOP for the administration of investigational immune effector cell therapy was established and presented at ONS Congress 2022.

A nursing unit at an accredited institution where administration of immune effector cell therapy (IECT) was pioneered developed a standard operating procedure (SOP) for its administration to use in tandem with research protocols. The SOP was described in an oral presentation at the 47th Annual Oncology Nursing Society (ONS) Congress.

Immune effector cell is defined as “a cell that has differentiated into a form capable of modulating or effecting a specific immune response,” explained Jessica Lenzo, MPH, BSN, RN, OCN, clinical practice lead at the Hospital of the University of Pennsylvania in Philadelphia. Chimeric antigen receptor T-cell (CAR-T) therapy is a type of IECT.

International standards for cell therapy were established by the Foundation for Accreditation of Cellular Therapy (FACT). However, FACT does not specify an administration technique and literature available on the topic is limited. “This knowledge gap often falls on the administering nurse,” the researchers wrote.

IECT administration is an emerging technique and many nursing units are just beginning to administer these products. The lack of standardized administration highlights a need for knowledge sharing. Therefore, Lenzo and colleagues sought to share the SOP in use at their institution. Their procedure is as follows:

  1. Place an 18- to 20-gauge peripheral IV catheter into a competent vein.
  2. Administer premedication.
  3. Verify the frozen cell product via a double-nursing check.
  4. Establish a free-flowing macro-drip gravity line with a Y-spike adaptor.
  5. Thaw the product in a 37°C water bath, then administer by gravity.
  6. Complete a back-washing procedure twice to ensure complete product delivery.

Vital signs are monitored every 15 minutes for the first hour, every 30 minutes for 2 hours, then hourly until treatment is complete.

Safety and efficacy of this technique is based on extensive experience with administration of cell products since 2010.

Read more of Oncology Nurse Advisor‘s coverage of the 47th Annual ONS Congress by visiting the conference page.

Reference

Lenzo J, Malul Y, Brock A. Nursing research unit standard operating procedure to guide administration of investigational immune effector cell therapy. Oral presentation at: 47th Annual ONS Congress; April 27-May 1, 2022; Anaheim, California.