Nursing interventions in autologous stem cell transplantation for autoimmune diseases

Abstract

Aims To identify clinical symptoms and nursing interventions for stem cell therapy in autoimmune diseases. Design This is a retrospective, cross‐sectional study. Methods This study was undertaken with patients diagnosed with type 1 diabetes or multiple sclerosis, undergoing autologous haematopoietic stem cell transplantation from January 2004 ‐ December 2018. Data were registered in a questionnaire, taken during the conditioning regimen comprising cyclophosphamide and rabbit anti‐thymocyte globulin. Descriptive statistics and Fisher's exact test were used for data analysis. Results There were 68 and 23 patients in the multiple sclerosis and type 1 diabetes groups respectively. Skin rash, nausea, vomiting and fever were more frequent and diverse in the type 1 diabetes group. Steroids were used as prophylaxis for anti‐thymocyte globulin‐associated allergic reactions in 97% of multiple sclerosis patients. Most of the identified symptoms and nursing interventions were more associated with one or other disease group (p < .05) and were more frequent in the type 1 diabetes group. Conclusion Patients with autoimmune diseases who underwent stem cell therapy present differences in their repertoire of adverse events and require disease‐specific nursing actions. Impact Our results may enable nurses to establish transplant and disease‐specific guidelines to improve prevention and management of adverse events and therefore optimize patient care and therapeutic success.