Oncology Emergencies Flashcards
(13 cards)
List the 4 biochemical features of tumour lysis syndrome (TLS).
Hyperuricaemia
Hyperphosphatemia
Hyperkalaemia
Hypocalcaemia
When is tumour lysis syndrome most commonly seen?
B cell Non-Hodgkins lymphoma
High white count ALL
What does Allopurionol do in TLS?
blocks further uric acid production
inhibits enzyme xanthine oxidase - required for forming uric acid
What does Rasburicase do in TLS?
catalyses the conversion of uric acid to allantoin (more soluble, more rapidly excreted by kidneys)
What disease process is Rasburicase CI in?
G6PD
risk of hemolysis & formation of methemoglobinemia
What is leukostasis also called?
symptomatic hyperleukocytosis
WCC >100
What is the major risk with leukostasis?
CNS or lung hemorrhage
Who is at risk for leukostasis?
AML > ALL
Management of leukostasis?
Platelet transfusion + urgent cyot-reductive treatment
What is mediastinal compression most common in?
T cell ALL
Temperature in febrile neutropenia?
Single temperature >38.3
Temp sustained >38 for >1hr
What are the most dangerous pathogens in febrile neutropenia?
Pseudomonas
Streptococcus
Graft Risk factors for Acute GvHD? (5)
HLA disparity (more mismatch = more GvHD) Unrelated donor Female donors (more HLA diversity) Older age of donor Cell source: PRC > BM > CB
Note: ABO/Rh mismatch is NOT a CI to BMT
