Beyond Transplant: Nursing Care of Patients Receiving Gemcitabine and Navelbine for Recurrent or Refractory Hodgkin's Disease

2.50
Hdl Handle:
http://hdl.handle.net/10755/165539
Category:
Abstract
Type:
Presentation
Title:
Beyond Transplant: Nursing Care of Patients Receiving Gemcitabine and Navelbine for Recurrent or Refractory Hodgkin's Disease
Author(s):
Schaindlin, Patricia
Author Details:
Patricia Schaindlin, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
Abstract:
Hodgkin's disease is an uncommon lymphoid malignancy with a stable annual incidence in the last half century of 7,500. Newly diagnosed patients are treated with curative intent using radiation therapy alone, chemotherapy alone, or a combination thereof. Controlling for stage of disease, between 65%-85% of all patients are cured with initial therapy. Patients who fail initial chemotherapy or combined modality therapy have a 35%-55% likelihood of being cured with high-dose chemotherapy followed by autologous stem cell transplant (ASCT). Patients with persistent refractory disease or relapse post-ASCT are offered palliative treatment. At our NCI-designated comprehensive cancer center we treated 10 patients who failed ASCT with Gemcitabine (1250 mg/m2) & Vinorelbine (30mg/m2) every two weeks. Treatment was administered through a central venous catheter access device over 30 minutes in the outpatient department. Common toxicities included mild myelosuppression, which was avoidable with GCSF 5mcg/kg on days 11-13 of every cycle, grade I post treatment nausea, and grade I constipation. One patient experienced Vinorelbine-induced pain during initial treatment, relieved immediately with opiates and was premedicated with oxycodone for all future treatments. No patients required admission. Nursing management of patients includes providing education regarding treatment plan, instruction for prevention and management strategies for expected toxicities, and providing ongoing psychosocial support. The overall quality of life is reported to be acceptable according to our patients who have been heavily pretreated and/or admitted to the hospital for several weeks during ASCT. To date three out of ten patients achieved a complete response after a minimum of 16 cycles (range 16-43, median 37), received a second ASCT, and one patient remains free from disease 164 days post second ASCT. Another patient achieved complete relief of his disease-related chest pain and was able to rejoin family in Puerto Rico. This presentation will describe the nursing management of patients who fail ASCT, provide an overview of relapsed/refractory Hodgkin's disease including treatment efficacy, toxicity, and education for this difficult-to-manage patient population. In addition, a novel treatment approach will be presented.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleBeyond Transplant: Nursing Care of Patients Receiving Gemcitabine and Navelbine for Recurrent or Refractory Hodgkin's Diseaseen_GB
dc.contributor.authorSchaindlin, Patriciaen_US
dc.author.detailsPatricia Schaindlin, Memorial Sloan-Kettering Cancer Center, New York, New York, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165539-
dc.description.abstractHodgkin's disease is an uncommon lymphoid malignancy with a stable annual incidence in the last half century of 7,500. Newly diagnosed patients are treated with curative intent using radiation therapy alone, chemotherapy alone, or a combination thereof. Controlling for stage of disease, between 65%-85% of all patients are cured with initial therapy. Patients who fail initial chemotherapy or combined modality therapy have a 35%-55% likelihood of being cured with high-dose chemotherapy followed by autologous stem cell transplant (ASCT). Patients with persistent refractory disease or relapse post-ASCT are offered palliative treatment. At our NCI-designated comprehensive cancer center we treated 10 patients who failed ASCT with Gemcitabine (1250 mg/m2) & Vinorelbine (30mg/m2) every two weeks. Treatment was administered through a central venous catheter access device over 30 minutes in the outpatient department. Common toxicities included mild myelosuppression, which was avoidable with GCSF 5mcg/kg on days 11-13 of every cycle, grade I post treatment nausea, and grade I constipation. One patient experienced Vinorelbine-induced pain during initial treatment, relieved immediately with opiates and was premedicated with oxycodone for all future treatments. No patients required admission. Nursing management of patients includes providing education regarding treatment plan, instruction for prevention and management strategies for expected toxicities, and providing ongoing psychosocial support. The overall quality of life is reported to be acceptable according to our patients who have been heavily pretreated and/or admitted to the hospital for several weeks during ASCT. To date three out of ten patients achieved a complete response after a minimum of 16 cycles (range 16-43, median 37), received a second ASCT, and one patient remains free from disease 164 days post second ASCT. Another patient achieved complete relief of his disease-related chest pain and was able to rejoin family in Puerto Rico. This presentation will describe the nursing management of patients who fail ASCT, provide an overview of relapsed/refractory Hodgkin's disease including treatment efficacy, toxicity, and education for this difficult-to-manage patient population. In addition, a novel treatment approach will be presented.en_GB
dc.date.available2011-10-27T12:20:29Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:20:29Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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