Moxetumomab Pasudotox: Clinical Experience in Relapsed/Refractory Hairy Cell Leukemia.

BACKGROUND: Moxetumomab pasudotox is a promising new therapy for the treatment of patients with relapsed/refractory hairy cell leukemia (R/R HCL), but practical guidance relating to its administration is limited. OBJECTIVES: This article describes clinical guidelines for the administration of moxetumomab pasudotox to patients with R/R HCL and presents related case studies. METHODS: A limited review of the literature on HCL was undertaken. FINDINGS: Nursing care of patients prescribed moxetumomab pasudotox includes monitoring clinical and laboratory parameters, managing side effects, being aware of signs of serious side effects, and maintaining patient hydration during administration.

Authentic caring occasions for patients in hairy cell leukemia clinical trials.

BACKGROUND: Rare diseases present challenges for patients, healthcare providers, and researchers. Rare disease communities exist for collaboration, dissemination of information, and to promote support for all community members. Patients with a rare disease desire to be supported through a rare disease community. Hairy cell leukemia (HCL) is a rare adult B-cell lymphocytic cancer that currently has no cure. OBJECTIVES: Patients with relapsed or refractory HCL may need to consider participation in a clinical trial. The research nurse can initiate a planned caring occasion based on Watson's Theory of Human Caring. The purpose of the planned caring occasion for patients with HCL in clinical trials is to establish authentic intentional caring encounters between the research nurse and patients and meaningful caring encounters between patients. OBSERVATIONS: Relapsed or refractory patients enrolled in an HCL clinical trial identify the trial as a microcommunity and the research nurse as an advocate and liaison. Patients seek support, empowerment, and the opportunity to connect with other patients with HCL. The planned caring occasion has the potential to provide a healing environment and facilitate shared experiences of living with HCL. The potential outcome for patients is strengthened holistic wellness.

The role of cladribine in the treatment of lymphoid malignancies.

PURPOSE/OBJECTIVES: To review clinical applications and nursing care activities for patients receiving cladribine, a synthetic antineoplastic agent used to treat lymphoid malignancies. DATA SOURCES: Clinical trial data, published articles, reports from oncology nurses, and personal observations. DATA SYNTHESIS: Cladribine has shown response rates of nearly 90% in patients with hairy cell leukemia after a single, seven-day continuous infusion. Toxicities generally are mild, predictable, and rapidly reversible after therapy is discontinued. CONCLUSIONS: Currently, cladribine primarily is used in hairy cell leukemia therapy. Clinical trials of cladribine in treating other hematologic malignancies, primarily chronic lymphocytic leukemia and non-Hodgkin's lymphoma, have demonstrated encouraging results. IMPLICATIONS FOR NURSING PRACTICE: Nursing care for patients who receive cladribine involves management of side effects, which commonly include myelosuppression and fever, and monitoring of hemoglobin, platelet levels, and body temperature. Fever develops in most patients receiving cladribine but is usually transient and easily treated with acetaminophen. Infection as a cause of fever must be ruled out, especially in patients with neutropenia.