Week 4: APL and supportive care Flashcards
What is this?
Disseminated intravascular coagulation; oncologic emergency indicative of APL (M3 AML)
What is the treatment of APL?
All-trans retinoic acid (directly addresses maturation block)
Arsinic tri-oxide (induces degradation of chimeric protein, induces apoptosis at higher doses)
What are the three contexts that nausea is considered?
Anticipatory, acute, delayed (>24 hours)
What is the central pathway of nausea and vomiting involved in? Where is it located?
Involved in the delayed phase of chemotherapy-induced nausea and vomiting; Primarily in the brain
What is the peripheral pathway of nausea and vomiting involved in? Where is it located?
Predominantly involved in the acute phase of chemotherapy-induced nausea and vomiting; Found in GI tract
What are the “Old School” drugs that can be helpful for nausea/vomiting?
ABCD: ativan (lorazepam), Benadryl (diphehydramine), Compazine (mostly olanzapine), Dexamethasone
What does NK1-receptor antagonists do in terms of nausea/vomiting? Where does it act?
Acts in brain to block substance P release
What do 5-HT3 receptor antagonists do in terms of nausea and vomiting? Where do they act?
Prevent binding of Serotonin onto vagal nerve in GI tract
What are the cancers that primarily form blood clots?
Pancreas, breast, prostate, bladder, lung and CNS cancers
What are the markers of hypercoagulability that are associated with poor survival?
elevated D-dimer, elevated INR
What is considered in the assessment of DVT risk?
site of cancer, platelet count, low Hgb, leukocyte count, BMI
What drug is the best to use for management of DVT in cancer?
low-molecular weight heparin (LMWH)
Why are bones so attractive for mets?
contains many growth factors
What are the cancers that mostly affect bone?
Breast and prostate cancers
What cancers respond to bone-directed treatment?
Meyloma, Breast and Renal Cell (NOT PROSTATE)
