Which chemotherapy agents are associated with SIADH?
Vincristine
Cyclophosphamide
Name 2 uses of ATRA.
- Neuroblastoma
- APML
What is the mechanism of action of asparaginase?
Asparagine depletion; tumor cells lack asparagine synthetase
What is the mechanism leading to hearing loss with cisplatin?
Production of reactive oxygen species, leading to cell death and damage to several areas of the cochlea
Mechanisms of action of rituximab
Monoclonal antibody against CD20; leads to depletion of CD20 cells in blood in lymph nodes, i.e. benign and malignant mature B-lymphocytes
Nelarabine: non-hematological toxicity
Neurological side effects, including: altered mental state, CNS toxicity, peripheral neuropathies, including demyelination (ascending neuropathy, GBS-like)
Risk seems increased if prior radiation therapy or intrathecal chemotherapy
Brentuximab vedotin:
- What is the target?
- List 2 diseases where it has been used
CD-30
Hodgkin lymphoma, ALCL
Describe the interaction between asparaginase and cytarabine/methotrexate
- Decrease the effect of cytarabine or MTX if given PRE
- Enhance the effect of cytarabine or MTX if given POST
Name 5 drugs interacting with HD methotrexate
- PPI
- Penicillin
- Penems
- PCP prophylaxis (Septra)
- Acyclovir
- Fluoroquinolones
- NSAIDs
List 5 chemotherapy agents considered as vesicants
- Vinca alkaloids: VCR, vinblastine, vinorelbine
- Anthracyclines, e.g. doxorubicine
- Paxels: docetaxel, paclitaxel
- Nitrogen mustard
- Epipodophyllotoxins
- Other: dactinomycin, mitomycin
Which antidotes exist in case of a vesicant?
- Hyaluronidase (vinca alkaloids)
- DMSO (doxorubicin)
- Sodium thiosulfate (nitrogen mustard)
When treating infiltration of a vesicant, it is usually recommended to use cold compresses. However, it is contraindicated with 2 types of substances. Which ones?
- Vinca alkaloids
- Epipodophyllotoxins
Thiotepa:
- Name 2 indications
- Name class
Indications: bladder cancer, malignant, meningeal neoplasms
Class: alkylating agent
What is bortezomib?
Indications?
- Proteasome inhibitor
- Refractory/relapsed B or T cell ALL
What is blinatumomab?
- Bispecific T-cell engager antibody, targeting CD19
- Refractory/relapsed precursor B-cell ALL
Name serious side effects (2) of blinatumomab
Cytokine release syndrome
Neurologic events, e.g. seizures, confusion, delirium, etc.
Name common symptoms of cytokine release syndrome
- Fever
- Organ dysfunction: encephalopathy, hepatic dysfunction, ARDS, cardiac dysfunction, acute kidney injury
- Hyperferritinemia
What is the management of cytokine release syndrome?
Prevention: dexamethasone given at time of infusion
Management:
- Supportive care
- Consider IL6 inhibitor (tocilizumab) is severe
- Steroids