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Introduction: In 2020, SARS-COV-2 appeared and the most dramatic pandemic since decades spread over the world. Waiting for vaccines development, cancer patients were at a higher risk of the COVID-19 infection and more likely to be subjects of a higher morbidity and mortality. This was a big challenge for oncology teams that have to treat patients avoiding contamination by SARS-Cov-2. The aim of the current work is to present oncology pharmacy practice guidelines during the COVID-19 pandemic to secure pharmaceutical care of the cancer patients and their evaluation, 6 months later. Material(s) and Method(s): In April 2020, the bureau of the French Society for Oncology Pharmacy proposed these recommendations according to the French High Authority of Health regarding the guidelines for Good Practice, slightly modified according to pandemic crisis situation. These guidelines were elaborated by a working group of 7 experts in oncology pharmacy practice. Furthermore, the guidelines were assessed by 31 independent reviewers. In January 2021, guidelines were then evaluated by 47 independent reviewers through a specific survey. Results and discussion: About guidelines elaboration, 100% of reviewers approved the guidelines and 90% of them suggested some improvements. The final version incorporates the best compromises and consists of 26 recommendations organized in 8 different sections. Six months later, 47 pharmacists, mainly from Cancer Centers (17%), University Teaching Hospitals (19%) and general hospitals (49%) evaluated guidelines. Eighty one percent of them have used them and 77% judged them useful or partially useful. 22 recommendations were applied by at least 60% of pharmacists [62-93] and only 4 were applied by around40%of reviewers. Conclusion(s): These guidelines allowed to secure the pharmaceutical management of cancer patients during the COVID-19 pandemic. The most challenged recommendations were linked to external services (i.e. teleworking) or procedure in severe conditions implementation.
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Background and importanceTisagenlecleucel is available in 50 mL and 250 mL frozen bags (containing 10–30 mL and 30–50 mL cell suspension, respectively). Tisagenlecleucel should be thawed at 37° C then infused within 30 min to maintain cell viability. Thawing time according to volumes is a critical point which is not known.Aim and objectivesWe evaluated in this work the thawing times of tisagenlecleucel according to volumes.Material and methodsEthylene vinyl acetate empty infusion bags were provided by Novartis. Freezing tisagenlecleucel matrix was reconstituted. Empty bags (50 mL and 250 mL) were respectively filled with 10 and 20 mL and 30, 40 and 50 mL of reconstituted matrix, then frozen at –150°C. To mimic real conditions, they were placed into a second sterile bag and thawed in a water bath at +37°C. To evaluate thawing duration, volume of remaining icicles was calculated by multiplying surface (GeoToolsoftware) by thickness (measured with a caliper). Furtheremore, the time to deliver the bags was measured by two different operators in triplicate.Results124±5 s and 191±30 s were necessary to achieve complete thawing of 50 mL bags filled at 10 and 20 mL, respectively. 155±16 s, 221±12 s and 240±6 s were needed to achieve complete thawing of 250 mL bags filled at 30, 40 and 50 mL, respectively. For a type of bag, decreasing volumes thawed faster, but 50 mL bags filled at 20 mL took longer to thaw than 250 mL bags filled at 30 mL (different spatial conformation and specific surfaces). Delivery of thawed bags from the pharmacy to the transplant unit was done in 4.5±0.21 min.Conclusion and relevanceThawing duration may vary by twice a function of volume. Mean lengths provide an optimal organisation in a circuit where every minute must be taken into account. A total thawing-addressing time rate of between 6.5 and 8.5 min means that the nursing team has almost 20 min to administer tisagenlecleucel.References and/or acknowledgementsConflict of interestNo conflict of interest