Nurses on the front lines of immunotherapy

A patient writes, “The Astros will win the World Series next year,” in bold print as Jaquelin Velasquez watches. The clinical nurse in Lymphoma and Myeloma isn’t interested in the accuracy of this prediction. She’s looking for signs of a serious side effect of immunotherapy. “If a patient’s handwriting deteriorates, it’s a red flag that they’re developing neurotoxicity,” Velasquez says. She explains that the handwriting test is part of a neurological assessment developed at MD Anderson for patients receiving CAR T-cell therapy. “Neurotoxicity can be fatal if we don’t intervene early and reverse the effects,” she says.  Velasquez has cared for immunotherapy patients since the first CAR T-cell therapy clinical trial here in 2015. The therapy involves the removal of a patient’s own T cells, which are then reengineered to find and destroy cancer proteins or targets. Next the cells are infused back into the patient’s body, where they attack the cancer cells. While there’s been great success with this type of treatment, it comes with a unique profile of toxicities that can be life-threatening. Making immunotherapy a safer treatment option Velasquez is one of many clinical, advanced practice and research nurses throughout MD Anderson who collaborate across the institution and the nation to identify and manage toxicity in patients treated with immunotherapy and thus bring a higher level of safety to this innovative treatment option. “On the front line of patient care, our nurses have been instrumental in helping us deliver immunotherapies in a safe fashion,” says Partow Kebriaei, M.D., a professor of Stem Cell Transplantation and Cellular Therapy. “Since the beginning, they’ve really led the charge in...