Authors (including presenting author) :
Liu TK(1), Chan SL(1), Mak SS(1), Choy CP(1), Chan CM(1)
Affiliation :
(1) Department of Clinical Oncology, Prince of Wales Hospital
Introduction :
Autologous haematopoietic stem cell transplant (AHSCT) is the standard treatment of some blood cancers and solid tumours. However, this is a long and complex journey, from pre-transplant assessment and preparation, apheresis catheter insertion and care, mobilization of stem cell, apheresis collection, conditioning chemotherapy, stem cell infusion, engraftment to post-transplant monitoring and care. Fragmentation of care results in increased risk of transplant failure. A successful transplant requires precise planning, effective coordination and efficient apheresis operation, carried out by the nurses who are experienced and competent in whole process of AHSCT and apheresis collection. The role of Cellular Therapy and Transplant Nurse (CT Nurse) and enhanced nursing model is established to improve the efficiency, safety of the AHSCT and ensure continuity of care.
Objectives :
(1) to achieve efficient apheresis collection of stem cell for AHSCT
(2) to minimize adverse events and unplanned admission
(3) to reduce doctor's consultation time during patient's AHSCT journey
Methodology :
An enhanced nursing service model of AHSCT were adopted and delivered through a newly defined nursing role, CT Nurse, in the AHSCT service of a haematology-oncology unit of a local hospital. Every case referred to haematology-oncology unit for AHSCT was followed by a CT Nurse and different points of care were provided according to the service model.
The apheresis collection outcome and transplant outcome of every case were collected retrospectively and analysed for the evaluation of the new model and CT Nurse.
Result & Outcome :
The enhanced model and CT Nurse implemented in 2021 and there were total 86 cases referred for AHSCT from 2021 to 2024. Referred cases included multiple myeloma, lymphoma and germ cell tumour. 77 cases were successfully proceed to apheresis collection with target yield achieved for transplantation. All of them received the conditioning chemotherapy and stem cell infusion and completed AHSCT with successful engraftment. 7 cases failed mobilization and 2 cases cancelled AHSCT before apheresis due to patients’ physical condition. Patients also reflected positive feedback on the care provided by CT Nurse.
