Diferencia entre revisiones de «Oncologic therapy related adverse events»
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===Panobinostat lactate (Farydak)=== | ===Panobinostat lactate (Farydak)=== | ||
*Adverse Events: | |||
**[[Cytopenia]] | **[[Cytopenia]] | ||
**[[Diarrhea]] | **[[Diarrhea]] | ||
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===Brentuximab vedotin (Adcetris)=== | ===Brentuximab vedotin (Adcetris)=== | ||
*[[Progressive multifocal leukoencephalopathy]] | *Adverse Events: | ||
*[[Peripheral neuropathy]] | **[[Progressive multifocal leukoencephalopathy]] | ||
*[[Bone marrow suppression]] | **[[Peripheral neuropathy]] | ||
**[[Bone marrow suppression]] | |||
==Immunotoxin== | ==Immunotoxin== | ||
===Moxetumomab pasudotox-tdfk (Lumoxiti)=== | ===Moxetumomab pasudotox-tdfk (Lumoxiti)=== | ||
*[[Hemolytic uremic syndrome]] | *Adverse Events: | ||
*[[Capillary leak syndrome]] | **[[Hemolytic uremic syndrome]] | ||
**[[Capillary leak syndrome]] | |||
==Bispecific T-cell engager (Blincyto)== | ==Bispecific T-cell engager (Blincyto)== | ||
===Blinatumomab=== | ===Blinatumomab=== | ||
*[[CNS depression]] | *Adverse Events: | ||
*[[Cytokine release syndrome]] | **[[CNS depression]] | ||
**[[Cytokine release syndrome]] | |||
==Disposition== | ==Disposition== | ||
Revisión del 18:33 6 mar 2020
Background
Many of the oncologic therapies currently employed involved immune system checkpoint inhibition which allow for improvement of T-cell activation towards cancer cells. This boost to the immune system can occur by many mechanisms that encompass the list of "novel" oncologic agents" described below.[1]
Clinical Features
- Many novel oncologic therapies and Biologic immunomodulators adverse reactions may mimic common ED presentations such as sepsis.
Types of novel oncologic agents
- Genetically engineered T cells
- CD19–chimeric antigen receptor (CAR)-T cell therapy
- Monoclonal Antibodies against PD-1 checkpoints
- Small-molecule inhibitors
- Monoclonal antibodies against cell surface antigens
- Antibody-drug conjugates
- Immunotoxins
- Bispecific T-cell engagers
Differential Diagnosis
- Decreased cellular immunity which an cause reactivation or new
- Neurologic syndromes
- Hematologic side effects
- Cardiac effects
- Allergic reactions
- Pulmonary
- Endocrine
- GI
- Perforations
- Clostridium difficile
- Acute bacterial infections
- Malignancies
- Non-melanoma skin cancers
- Lymphoma
CAR-T cells medications
Tisagenlecleucel (Kymriah)
- Indications:
- Acute lymphoblastic leukemia
- Large B-cell lymphoma
- Adverse events include:
Axicabtagene ciloleucel (Yescarta)
- Indications:
- Acute lymphoblastic leukemia
- Large B-cell lymphoma
- Adverse events include:
PD1 Monoclonal Antibodies
Pembrolizumab (Keytruda)
- A PD-1 humanized mouse mAb
- Adverse events include:
- Infusion reactions
- Musculoskeletal pain
- Dyspnea
- Diarrhea
- (Arrhythmias
- (Myocardial infarctions
- (Pericardial effusions
Nivolumab (OPDIVO)
- A PD-1 human IgG4 mAb
- Adverse events include:
Small molecule inhibitors
Enasidenib (IDHIFA)
- Adverse Events:
Ivosidenib (Tibsovo)
- Adverse events
Midostaurin (Rydapt)
- Adverse Events:
- Epistaxis
Nilotinib (Tasigna)
- Adverse events
- QT prolongation
- Sudden death
- Myelosuppression
- Arterial thrombosis
- Pancreatitis
- Hepatotoxicity
Bosutinib (Bosulif)
- Adverse Events:
- Myelosuppression
- Diarrhea
- Pancreatitis
- Hepatotoxicity
- Cardiac arrest
- Arrythmia
- ACS
Ibrutinib (Imbruvica)
- Adverse Events:
Acalabrutinib (Calquence)
Duvelisib (Copiktra)
Copanlisib (Aliqopa)
- Adverse Events:
Panobinostat lactate (Farydak)
- Adverse Events:
Ixazomib citrate (Ninlaro)
- Adverse Events:
Venetoclax (Venclexta)
- Adverse Events:
- Tumor lysis syndrome
- Bone marrow suppression
- Autoimmune hemolytic anemia
Monoclonal antibodies against cell surface antigens
Ofatumumab (Arzerra)
- Adverse Events:
- Reactivation of Hepatitis B virus infection
- Progressive multifocal leukoencephalopathy
- Tumor lysis syndrome
- Infusion reaction
- Cytopenias
Obinutuzumab (Gazyva)
- Adverse Events:
Daratumumab (Darzalex)
Elotuzumab (Empliciti)
- Adverse Events:
Empliciti (Poteligeo)
Antibody-drug conjugates
Inotuzumab ozogamicin (Besponsa)
- Adverse Events:
- Sinusoid occlusion syndrome
- Infusion reactions
- Thrombocytopenia
- Neutropenia
- QT prolongation
Gemtuzumab ozogamicin (Mylotarg)
- Adverse Events:
- Thrombocytopenia
- Transaminitis
- Veno-oclusions
Brentuximab vedotin (Adcetris)
- Adverse Events:
Immunotoxin
Moxetumomab pasudotox-tdfk (Lumoxiti)
- Adverse Events:
Bispecific T-cell engager (Blincyto)
Blinatumomab
- Adverse Events:
Disposition
See Also
External Links
References
- ↑ Shah, M., Rajha, E., DiNardo, C., Muckey, E., Wierda, W. G., & Yeung, S. C. J. (2020). Adverse Events of Novel Therapies for Hematologic Malignancies: What Emergency Physicians Should Know. Annals of Emergency Medicine, 75(2), 264–286. https://doi.org/10.1016/j.annemergmed.2019.07.015