Oncologic Emergencies
This is the most common complication associated with CAR-T cell therapy.
What is cytokine release syndrome.
This gender is more prone to CINV.
What is female?
This must be within normal range before initiating an ESA.
What is iron?
Folinic acid (leucovorin) is given along with this agent to prevent toxicity.
What is methotrexate?
These three cancers are most commonly associated with Lynch syndrome.
What are colorectal, endometrial, and ovarian cancers?
Hypercalcemia of malignancy is most common in these types of cancers.
Lung
Most common:
Lung: 35%
Breast: 25%
Myeloma and Lymphoma: 14%
GU: 6%
Name at least two receptors/pathways for CINV.
What are serotonin, substance P, dopamine, prostaglandin, histamine, and cannabinoid pathways?
Generic name of the colony stimulating agent(s) most commonly used to prevent neutropenia.
What is filgrastim/pegfilgrastim?
This medication is given for doxorubicin-induced cardiotoxicity.
What is dexrazoxane?
Dexrazoxane is an EDTA-like chelator, which may prevent anthracycline damage by binding iron that is released from intracellular storage secondary to lipid peroxidation
Other than lung cancer, these three cancers can be treated with a HER2 inhibitor (trastuzumab).
What are breast, gastric, and esophageal cancers.
The four common electrolyte disturbances seen in tumor lysis syndrome.
What are hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia?
This type of CINV occurs despite appropriate antiemetic prophylaxis.
What is breakthrough CINV?
Definition of febrile neutropenia
What is ANC <500 AND Temp >38C?
These agents are known to cause hemorrhagic cystitis.
What are alkylating agents (cyclophosphamide and ifosphamide)?
This is the most common complication associated with nivolimumab and pembrolizumab.
What is an autoimmune reaction?
Specifically, pneumonitis, carditis, and colitis
This is the first-line treatment for patients who experience cytokine release syndrome.
What is an IL-6 inhibitor (tocilizumab)?
This is a protective factor for CINV.
What is smoking?
This score is used to determine if a patient with febrile neutropenia warrants admission.
What is the MASCC risk index?
This medication is given in radiation-induced xerostomia and cisplatin toxicity.
What is amifostine?
Amifostine is a prodrug that is metabolized by alkaline phosphatase to an active free thiol metabolite. The active thiol metabolite reduces cytotoxicity by binding to and detoxifying reactive metabolites of cisplatin and alkylating agents and by acting as a scavenger of free radicals that may develop in tissues exposed to cisplatin or radiation. These actions occur more readily in normal tissue than in tumors because of the greater phosphatase activity, higher pH, and better vascularity in normal tissue , resulting in selective protection of normal tissues
This is a common side effect of trastuzumab.
What is cardiotoxicity?
DH is diagnosed with philadeplphia chromosome-positive pre-B cell ALL and began HyperCVAD, arm "A" with a TKI.
On day 2 of chemo, his labs were notable for WBC 42, BUN 36, SCr 2.2, K 5.7, Phos 4.9, LDH 2810, and uric acid 8.6.
This is the appropriate next step.
What is aggressive hydration?
This 5-HT3 inhibitor has a long half life and is given only once per chemo cycle.
What is palonosetron (Aloxi)?
NH is a 65 YOM undergoing his third cycle of chemo for extensive stage SCLC. At the time of diagnosis, his Hgb was 13, but today it is 9. PMH is significant for COPD. Current weight is 75kg.
This treatment is indicated next for NH.
What is epoetin alpha?
These two agents are used to treat hemorrhagic cystitis caused by certain chemo agents.
What are hydration and Mesna?
Most chemo doses are weight-based using this measure (with units).
What is BSA (m2)?