Haem Malignancy- treatment Flashcards
(4 cards)
Tt of Haem Malignancies
Main Modalities
4 Major modalities of Tt:
*Chemotherapy
*Immunotherapy
*Radiotherapy (for CNS prophylaxis, bulky disease, palliative)
*Hematopoietic stem cell transplant
Chemotherapy Phases
Chemotherapy Phases:
1. Induction
* Goal: achieve remission
* Reduces tumor/abnormal cell burden
2. Consolidation
* Eliminates residual microscopic disease
* Aims for cure
3. Maintenance
* Especially used in ALL
* Helps prolong remission
=>Radiotherapy: May also be used adjunctively in leukemia/lymphoma
=>Intrathecal chemotherapy: For CNS lymphoma
- Drugs: Methotrexate, Cytarabine
Immunotherapy
Immunotherapy
*works by stimulating the immune system - increases efficiency to find and attack cancer cells.
Types:
=>Immune Check point Inhibitors-
-Inhibit immune check points eg- Ipilimumab
=>Oncolytic virus therapy- uses viruses to infect and kill cancer cells
=>CAR-T Cell Therapy (Chimeric Antigen Receptor T-cells):
* Genetically modified T-cells target specific cancer cells (e.g., in ALL)
Toxicities:
* Anaphylaxis
* Cytokine release syndrome (CRS)
* Neurological toxicity
CRS may require:
* IV fluids * Vasopressors * Respiratory or renal support (RRT)
Immune check points- normal components of immune system which keep immune system in check. By inhibiting these check points- immune sys can now work more effectively
Ifosfamide Neurotoxicity
Ifosfamide Neurotoxicity
Usage:
* Used in the treatment of lymphomas
Neurotoxic Effects:
* Confusion
* Auditory/visual hallucinations
* Personality changes, anxiety
* Extrapyramidal symptoms
* Seizures, coma
⸻
Timeline:
* Symptoms typically occur 24–48 hours post-infusion
* Improvement seen within 48 hours of discontinuation
⸻
Risk Factors:
* Low serum albumin (<3.5 g/dL)
* Low serum sodium
* Renal impairment (↑ serum creatinine)
* Bulky abdominal disease
Neurotoxic effects- mnemonic- ESCAPE
