Critical Thinking Key to Effective Management of Adverse Effects in Lymphoma

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AEs associated with lymphoma therapy include  anemia, thrombocytopenia, neutropenia, mucocutaneous reactions, and fatigue.
AEs associated with lymphoma therapy include anemia, thrombocytopenia, neutropenia, mucocutaneous reactions, and fatigue.

Significant shifts in the management of lymphoma continue thanks to new innovative immunotherapies. New treatments are leading to notable improvements. However, proper management of the myriad of treatment-related adverse events (AEs) associated with these newer therapies is becoming a significant challenge for oncology nurses. In a study published in the Clinical Journal of Oncology Nursing, researchers suggest that in order to meet this challenge adequately, oncology nurses must be precise in grading toxicities and have effective interdisciplinary and patient-clinician communication.

“Keeping up with new drugs, particularly oral drugs, new regimens, and their respective side effect management is a staggering challenge for oncology nurses,” said study author Amy Goodrich, MSN, CRNP, a nurse practitioner at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore, Maryland.

Goodrich and her co-authors identified nursing challenges in the management of AEs associated with lymphoma treatment, and they examined how strategies in critical thinking can be used to overcome various hurdles.


Lymphomas are currently treated with rituximab (Rituxan), bortezomib (Velcade), lenalidomide (Revlimid), and idelalisib (Zydelig) and bendamustine (Treanda) along with others. Subsequently, now more than ever, oncology nurses must be highly accurate in grading peripheral neuropathy, neutropenia, and other AEs related to new lymphoma treatment paradigms. Goodrich and colleagues conducted a comprehensive literature search in oncology nursing, nursing education, and critical thinking.

They also examined participant responses to pretests and posttests at nursing education programs. Oncology nurses are required to be as knowledgeable as possible when it comes to grading peripheral neuropathy and neutropenia as they relate to specific lymphoma regimens. The study suggests step-by-step means of accomplishing precise grading.  

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