Management of uncommon chemotherapy-induced emergencies

Morgan, Clare; Tillett, Tania; Braybrooke, Jeremy; Ajithkumar, TV

doi:10.1016/s1470-2045(10)70208-4

Cited by 41 publications

(16 citation statements)

References 71 publications

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“…Typhlitis occurs in approximately 5% of patients with hematologic malignancies. [51][52][53] Mucosal injury and profound neutropenia allow secondary bowel wall infection and transmural inflammation. The cecum is most often involved and patients present with right lower quadrant pain or peritoneal signs.…”

Section: Typhlitis/neutropenic Enterocolitismentioning

confidence: 99%

Life-Threatening Infection in Transplant Recipients

O'Shea

Humar

2013

Critical Care Clinics

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Modern post-transplant care pathways commonly encompass periods of critical care support. Infectious events account for many of these interactions making critical care physicians integral members of multidisciplinary transplant teams. Despite continuing advances in clinical care and infection prophylaxis, the morbidity and mortality attributable to infection post-transplant remains considerable. Emerging entities constantly add to the breadth of potential opportunistic pathogens. Individualized risk assessments, rapid and thorough diagnostic evaluation, and prompt initiation of appropriate antimicrobial therapies are essential. The approach to managing transplant recipients with infection in critical care is discussed and common and emerging opportunistic pathogens are reviewed.

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Section: Typhlitis/neutropenic Enterocolitismentioning

confidence: 99%

Life-Threatening Infection in Transplant Recipients

O'Shea

Humar

2013

Critical Care Clinics

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“…Early diagnosis of cholecystitis is not easy in critically ill and often unconscious patients undergoing intensive treatment (respiratory therapy, sedation). Such diagnosis may be further prolonged until acute abdominal pain is reported and/or the patient's general condition worsens as a consequence of gallbladder necrosis or perforation [ 2 – 5 ]. The modalities of choice for ACC diagnosis are ultrasound and computed tomography, which reveal the characteristic features of cholecystitis.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy for acalculous cholecystitis in a neutropenic patient after chemotherapy for acute lymphoblastic leukemia

Pielaciński

Ejduk

Wróblewski

et al. 2014

wiitm

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Acute acalculous cholecystitis (ACC) is most frequently reported in critically ill patients following sepsis, extensive injury or surgery. It is rather uncommon as a chemotherapy-induced complication, which is usually life-threatening in neutropenic patients subjected to myelosuppressive therapy. A 23-year-old patient with acute lymphoblastic leukemia was subjected to myelosuppressive chemotherapy (cyclophosphamide, cytarabine, pegaspargase). After the first chemotherapy cycle the patient was neutropenic and feverish; she presented with vomiting and pain in the right epigastrium. Ultrasound demonstrated an acalculous gallbladder with wall thickening up to 14 mm. The ACC was diagnosed. Medical therapy included a broad spectrum antibiotic regimen and granulocyte-colony stimulating factors. On the second day after ACC diagnosis the patient's general condition worsened. Laparoscopic cholecystectomy was performed. The resected gallbladder showed no signs of bacterial or leukemic infiltrates. The postoperative course was uneventful. In the management of neutropenic patients with ACC surgical treatment is as important as pharmacological therapy.

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“…Causative chemotherapeutic agents include asparaginase, ifosfamide, paclitaxel, cisplatin, vinorelbine, cytarabine, and tretinoin (27). Asparaginase-associated pancreatitis has a prevalence of approximately 2%-16% (27,28). Butt et al described six cases of oxaliplatin-induced pancreatitis (29).…”

Section: Pancreasmentioning

confidence: 99%

“…At CT, pancreatitis is seen as areas of low attenuation or diffuse edema in the pancreas, with peripancreatic fat stranding and peripancreatic fluid. Treatment is usually supportive, and, given the high risk for mortality, alternate chemotherapy is administered if necessary (27).…”

Section: Pancreasmentioning

confidence: 99%

Abdominal and Pelvic Complications of Nonoperative Oncologic Therapy

Viswanathan¹,

Truong²,

Sagebiel³

et al. 2014

RadioGraphics

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Oncologic patients are treated with a combination of chemotherapy, radiation therapy, and surgery. Advances in therapeutic options have greatly improved the survival of patients with cancer. Examples of these advances are newer chemotherapeutic agents that target the cell receptors and advanced radiation therapy delivery systems. It is imperative that radiologists be aware of the variety of imaging findings seen after therapy in patients with cancer. Complications may occur with classic cytotoxic therapies (eg, 5-fluorouracil), usually at higher or prolonged doses or when administered to radiosensitive areas. Newer targeted systemic agents, such as bevacizumab and imatinib, have associated characteristic toxicities because their effects on cells do not depend on dose. Radiation may induce early and late effects in local normal tissues that may be seen at imaging. Imaging findings after chemotherapy include fatty liver, pseudocirrhosis, hepatic veno-occlusive disease, and splenic rupture. Complications of radiation therapy include large and small bowel strictures and radiation-induced hepatitis and tumors. Awareness of the various therapeutic options and knowledge of the spectrum of posttherapeutic complications allows radiologists to provide a comprehensive report that may impact patient management.

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Management of uncommon chemotherapy-induced emergencies

Cited by 41 publications

References 71 publications

Life-Threatening Infection in Transplant Recipients

Life-Threatening Infection in Transplant Recipients

Laparoscopic cholecystectomy for acalculous cholecystitis in a neutropenic patient after chemotherapy for acute lymphoblastic leukemia

Abdominal and Pelvic Complications of Nonoperative Oncologic Therapy

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