Background: Bispecific T-cell engaging antibodies (BsAbs) are novel agents used to treat B-cell non-Hodgkin lymphoma (B-NHL); these agents demonstrate a different toxicity profile compared with standard chemoimmunotherapy.

Objective: To describe common adverse events (AEs) experienced by patients with B-NHL during BsAb treatment.

Methods: MEDLINE, EMCARE, and EMBASE were searched for relevant studies. Prospective interventional clinical trials of CD20-CD3 BsAbs in late development reporting on safety data for B-NHL patients, published until March 2023, were included.

Results: This search identified 1481 records; 28 met the inclusion criteria. Cytokine release syndrome (CRS), neutropenia, pyrexia, and anemia were the most commonly reported AEs. CRS primarily occurred during the first cycle of treatment and was mostly low grade; 14 publications (48%) reported a grade ≥3; however, these occurred in less than 10% of patients. Mitigation strategies included premedication with corticosteroids, antipyretics, and antihistamines; step-up dosing; and planned hospitalizations. Two articles reported common signs and symptoms of CRS, which included pyrexia (98% and 99%), chills (13% and 35%), tachycardia (27% and 28%), and hypotension (24% and 38%). Supportive management, tocilizumab, and corticosteroids were widely used (reported in 16/28 studies) for the treatment of CRS. Patient risk factors for CRS included high tumor burden, bone marrow infiltration, and circulating disease.

Conclusions: The AE profile of BsAbs requires specialized nurses, skilled in assessing patients for risk factors and recognizing signs and symptoms of AEs.

Implications for practice: Findings from this review will contribute to cancer nurses' knowledge of CD20-CD3 BsAbs for B-NHL, optimizing the quality and safety of patient care.

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背景：

双特异性 T 细胞结合抗体（BsAbs）用于治疗 B 细胞非霍奇金淋巴瘤（B-NHL），这类药物表现出不同于标准化疗免疫疗法的毒性特征。

目的：

描述接受 BsAb 治疗的 B-NHL 患者常见的不良事件（AEs）。

方法：

通过 MEDLINE、EMCAR 和 EMBASE 搜索相关研究。纳入标准是关于 CD20-CD3 BsAbs 的前瞻性干预性临床试验，这些试验报告了截至 2023 年 3 月的 B-NHL 患者的安全性数据。

结果：

此次搜索共识别出 1481 条记录；其中 28 篇符合纳入标准。细胞因子释放综合征（CRS）、中性粒细胞减少、发热和贫血是最常见的不良事件。CRS 主要发生在治疗的第一个周期，并且大多数是低级别的；有 14 篇文献 (48%) 报告了 ≥3 级的 CRS，但这些情况在少于 10% 的患者中发生。缓解策略包括使用皮质类固醇、退热药和抗组胺药物进行预处理；逐步增加剂量以及计划住院治疗。两篇文章报告了 CRS 常见的症状和体征，其中包括发热（98% 和 99%）、寒战（13% 和 35%）、心动过速（27% 和 28%）和低血压（24% 和 38%）。支持性管理、托珠单抗和皮质类固醇广泛用于治疗 CRS，这些措施在 28 篇文献中的 16 篇中被报告。CRS 的患者风险因素包括高肿瘤负荷、骨髓浸润以及循环疾病。

结论：

BsAbs 的不良事件特征需要专业的护士来评估患者的危险因素并识别 AE 的迹象和症状。

实践影响：

本综述的发现将有助于癌症护士了解 CD20-CD3 BsAbs 在 B-NHL 中的应用，优化患者护理的质量和安全性。