Nurses Lead Toxicity Monitoring in Indolent Lymphoma Care

Nurses are essential partners in guiding patients and caregivers through the complex landscape of novel immunotherapy combinations for indolent lymphoma, according to Lorenzo Falchi, MD.

Falchi, a lymphoma specialist at Memorial Sloan Kettering Cancer Center in New York, New York, spoke with Oncology Nursing News at the 2025 Society of Hematologic Oncology (SOHO) Annual Meeting, where he presented on novel treatment strategies in this setting.

Falchi emphasized that early and consistent nursing involvement is critical for both education and toxicity monitoring. Cytokine release syndrome (CRS), neurotoxicity, and infectious complications are the most frequent and concerning events, particularly in the first 1 to 4 cycles of treatment with bispecific antibodies. Nurses not only reinforce physician-provided education but also ensure that patients and caregivers truly understand and retain the information. This includes the use of written materials, teach-back strategies, and supplying essential tools such as thermometers and blood pressure monitors for at-home monitoring.

He also underscored the importance of identifying reliable caregivers and maintaining regular communication during treatment initiation. By combining close observation, proactive education, and patient reassurance, nurses provide an indispensable safety net that supports patients and caregivers throughout the course of immunotherapy.

Transcript

Nurses are the first point of contact and, sometimes, are the figures that patients trust the most. We rely a lot on our nurses for the educational piece. Education is very important to deliver in a comprehensive way, making sure patients and their caregivers understand.

The first step is to identify a caregiver, having their contact information and some degree of certainty or confidence that those are reliable, compliant caregivers, because sometimes patients may not be well enough to pick up the phone to answer, or they may be confused, so having a caregiver is important. That’s the first piece.

The second piece is, yes, we do provide education as physicians—it’s part of our job to provide education about signs and symptoms of CRS and any other complication that they can experience with bispecific antibodies. But oftentimes we leave the room and the patient is still confused, or they haven’t retained everything that we just said. [Nurses provide] an additional layer of education, sometimes putting things in writing, offering pamphlets or other educational material.

There are ways to provide patients with a thermometer, blood pressure machine, ice packs, or things that are provided, making sure that those are in the home for when treatment starts, and really have that constant contact at the beginning of treatment with both the patient and the caregiver.

A lot of these adverse effects that we talked about—the CRS, the neurotoxicity, and, in part, the infectious complications—they tend to occur primarily in the first 1 to 4 cycles of therapy. That’s the heaviest part in terms of assistance and education. The nurses play an enormous role in not only delivering education to patients, but also making sure that the education goes through and is taught back by the patient. That gives us, as providers, a lot of reassurance.

This transcript has been edited for clarity and conciseness.