Tumor Lysis Syndrome Associated with Monoclonal Antibodies in Patients with Multiple Myeloma: A Pharmacovigilance Study Based on the FAERS Database

Clinical Pharmacology & Therapeutics, Год журнала: 2023, Номер 114(1), С. 211 - 219

Опубликована: Апрель 22, 2023

Although some tumor lysis syndrome (TLS) cases have been reported with patients multiple myeloma (MM) taking monoclonal antibodies (mAbs), the association between TLS and mAbs remains mostly unknown. We aim to investigate describe clinical features. conducted a disproportionality analysis link by excluding known confounders compared other anticancer drugs. The was evaluated using information component (IC). Drug–drug interaction signals were calculated based on Ω shrinkage measure. Parametric distribution goodness‐of‐fit test used for time‐to‐onset analysis. From 2016 Q1, 2022 Q4, total of 274 in US Food Drug Administration Adverse Event Reporting System (FAERS) database. There 27% who died 20.1% occurred life‐threatening situation. Daratumumab, elotuzumab, belantamab mafodotin presented robust disproportionate signal after (IC 025 > 0). Daratumumab had highest among all drugs MM. Reported showed median days daratumumab, isatuximab, 1.5, 14.5, 5.5, 5.5 days, respectively. drug–drug co‐administration increase urate, induce hyperkalemia, or hypocalcemia elevated reporting frequency (Ω Our postmarketing pharmacovigilance detected Additional studies epidemiological study designs that can validate these findings are warranted.

Язык: Английский

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Multidisciplinary Approach to Spinal Metastases and Metastatic Spinal Cord Compression—A New Integrative Flowchart for Patient Management

Cancers, Год журнала: 2023, Номер 15(6), С. 1796 - 1796

Опубликована: Март 16, 2023

Metastatic spine disease (MSD) and metastatic spinal cord compression (MSCC) are major causes of permanent neurological damage long-term disability for cancer patients. The development MSD is pathophysiologically framed by a cooperative interaction between general mechanisms bone growth specific metastases (SM) expansion. SM most commonly affects the thoracic spine, even though multiple segments may be affected concomitantly. great majority extradural, while intradural-extramedullary intramedullary less frequently seen. management patients with particularly complex challenging, factors-such as stability status, primary tumor radio chemosensitivity, biological burden, patient performance status comorbidities, patient's oncological prognosis-influencing clinical decision-making process. Different frameworks were developed in order to systematize support this A multidisciplinary, personalized approach, enriched expertise each involved specialty, crucial. We reviewed recent evidence proposed an updated algorithmic approach according scenario patient. flowchart-based offers evidence-based MSD, providing valuable decision tool context high uncertainty quick-acting need.

Язык: Английский

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Selenium Attenuates Radiation Colitis by Regulating cGAS‐STING Signaling

Advanced Science, Год журнала: 2024, Номер unknown

Опубликована: Сен. 30, 2024

Abstract Radiation colitis is one of the most common complications in patients undergoing pelvic radiotherapy and there no effective treatment clinic. Therefore, searching for agents radiation urgently needed. Herein, it found that essential element selenium (Se) protective against through inhibiting X‐ray‐induced apoptosis, cell cycle arrest, inflammation with involvement balancing generation reactive oxygen species after irradiation. Mechanistically, Se, especially nanoparticles (SeNPs), induced selenoprotein expression then functioned to effectively restrain DNA damage response, which reduced intestinal injury. Additionally, SeNPs also restrained cyclic GMP‐AMP synthas (cGAS)‐ stimulator interferon genes (STING)‐TBK1‐IRF3 signaling pathway cascade, thereby blocking transcription inflammatory cytokine gene, IL‐6 TNF‐α, thus alleviating inflammation. Moreover, inducing expression, such as GPX4, vivo can regulate microenvironment immunity gut microbiota attenuate radiation‐induced by oxidative stress maintaining homeostasis. Together, these results unravel a previously unidentified modulation role but suppressing cGAS‐STING‐TBK1‐IRF3 cascade.

Язык: Английский

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Multiple Myeloma

Home Healthcare Now, Год журнала: 2024, Номер 42(3), С. 140 - 149

Опубликована: Май 1, 2024

Multiple myeloma (MM) is a cancer that arises from plasma cells in bone marrow. Approximately 35,730 Americans received new diagnosis and MM will claim the lives of an estimated 12,590 people 2023. Complications disease process include anemia, leukopenia, thrombocytopenia, renal failure, severe pain, loss, hypercalcemia. Patients with have high risk for pathological fractures. For most forms there are effective treatments may result long-term remission using multi-drug regimens. Although medications approved United States to treat generally produce good outcomes, they serious, potentially life-threatening adverse effects. In addition, patients specific genetic variations at relapse. Communication oncology team early intervention event effects medications, complications process, or evidence relapse important obtain best possible outcome. easily overwhelmed three- four-drug treatment regimen some drugs given intravenously and/or subcutaneously clinic, others taken orally home on days each 28-day cycle. Home care nursing needed assess tolerance, effects, address patient concerns. Medication management teaching very guiding safely manage schedule changes daily. fractures serious injury if should fall supports need physical occupational therapy prevention safety education exercise programs help avert decline functional status combat cancer-related fatigue.

Язык: Английский

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Acute Oncologic Complications: Clinical–Therapeutic Management in Critical Care and Emergency Departments

Current Oncology, Год журнала: 2023, Номер 30(8), С. 7315 - 7334

Опубликована: Авг. 2, 2023

Introduction. It is now known that cancer a major public health problem; on the other hand, it less known, or rather, often underestimated, significant percentage of patients will experience cancer-related emergency. These conditions, depending severity, may require treatment in intensive care emergency departments. In addition, not uncommon for tumor pathology to manifest itself directly, first instance, with related The unit proves be fundamental and central management patients. Many cases are diagnosed instance as result symptoms lead patient’s admittance into room. Materials Methods. This narrative review aims analyze impact acute oncological setting role physician their management. A search was conducted over period January 1981–April 2023 using main scientific platforms, including PubMed, Scopus, Medline, Embase Google scholar, 156 papers were analyzed. Results. To probe emergencies increasingly overcrowded departments, we analyzed following pathologies: neurological emergencies, metabolic endocrinological vascular malignant effusions, neutropenic fever anemia. Discussion/Conclusions. Our analysis found redefinition department connected oncology necessary, considering only disease strict sense, but also comorbidities, palliative setting. need redesign an able manage end life appears clear, especially when this turns out severe effects cannot managed at home integrated care. conclusion, paradigm mandatory, such integration between various specialists belonging medicine department. Therefore, our work provide what can handbook detect, diagnose treat hoping patient multidisciplinary perspective, which could regular presence oncologist

Язык: Английский

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Emergencies in Hematology: Why, When and How I Treat?

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(24), С. 7572 - 7572

Опубликована: Дек. 12, 2024

Hematological emergencies are critical medical conditions that require immediate attention due to their rapid progression and life-threatening nature. As various examples, hypercalcemia, often associated with cancers such as multiple myeloma, can lead severe neurological cardiac dysfunction. Hyperleukocytosis, common in acute myeloid leukemias, increases the risk of leukostasis multiorgan failure. Sickle cell crisis, a complication sickle disease, results from vaso-occlusion, leading pain tissue ischemia. Tumor lysis syndrome, reported cases destruction cancer cells, causes electrolyte imbalances kidney injury. Acute transfusion reactions, fundamental hematological conditions, range mild allergic responses hemolysis shock, requiring prompt management. Disseminated intravascular coagulation, involving excessive coagulation bleeding, is commonly triggered by malignancies, first phases promyelocytic leukemia. Recently, era bispecific antibodies chimeric antigen receptor T cytokine release syndrome manifestation must be recognized promptly treated. Understanding pathophysiology, recognizing clinical manifestations, ensuring adequate diagnostic strategies management approaches for each condition central early intervention improving patient outcomes reducing mortality.

Язык: Английский

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Clinical evaluation and outcome in heart failure patients receiving chemotherapy with different anti‐cancer agents

ESC Heart Failure, Год журнала: 2025, Номер unknown

Опубликована: Янв. 13, 2025

Abstract Background The optimal strategy for modern chemotherapy should be based on a comprehensive approach cancer patients with cardiovascular diseases. Therefore, cardio‐oncology has received increasing attention owing to the cardiotoxic effects of anti‐cancer therapies. Objectives We aimed evaluate clinical characteristics and outcomes heart failure (HF) who compared those matched cohort HF did not receive chemotherapy, using real‐world data. Methods This study was Diagnosis Procedure Combination (DPC) database Japanese Registry All Cardiac Vascular Diseases (JROAD). identified 1 328 113 were hospitalized between April 2012 March 2021. propensity score (PS) estimated logistic regression model, as dependent variable, clinically score‐matched analysis 11 532 or without chemotherapy. primary endpoint readmission. Results Colon, lung, breast prostate cancers accounted >60% all types. After PS matching, readmission significantly more frequently observed in than [odds ratio (OR), 1.26; 95% confidence interval (CI) 1.17–1.36, P < 0.01]. In particular, treatment epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) (OR, 1.69; CI 1.39–2.07), taxane 2.95; 2.11–4.12), anthracyclines 1.86; 1.19–2.90) fluorouracil agents 1.65; 1.18–2.30) caused higher risk Conclusions Medical providers need monitor follow‐up HF, depending types cancer.

Язык: Английский

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Navigating Emergency Management of Cancer Patients: A Retrospective Study on First-Time, End-Stage, and Other Established Diagnoses in a High Turnover Emergency County Hospital

Medicina, Год журнала: 2025, Номер 61(1), С. 133 - 133

Опубликована: Янв. 15, 2025

Background and Objectives: The incidence prevalence of cancers are increasing worldwide, with special emphasis placed on prevention, early detection, the development new therapeutic strategies that strongly impact patient outcomes. Limited data available about emergency care’s role in treating patients cancer. This study aims to determine burden end-stage first-time diagnosis cancer care a high-turnover center. Materials Methods: A retrospective observational was conducted identify requesting emergent aid for cancer-related symptoms Emergency Department “St. Spiridon” Hospital from Iasi (Romania) between 1 October 2022 30 September 2023. proportion demographic characteristics those who received during visit were evaluated. Risk analysis performed understand these patients’ needs (such as medical care, surgical specialty consults, intensive ward admission, other hospital transfers) immediate outcomes in-hospital mortality home discharge). Results: 2318 requested (patient presentation rate 3.08%), which 444 (19.15%) diagnosed first time, 616 (26.57%) at end-stage. First-time had significantly different distribution types (p < 0.001), more likely need any form require consultation, or be admitted (OR 2.65, 95% CI: 2.12–3.32; p 0.001; OR 3.28, 2.48–4.35, 2.09, 1.70–2.59; 0.001, respectively) but less severe, while address repeatedly room 1.86, 1.32–2.59; = 0.001) higher odds needing assisted ventilation death (OR-4.63, 1.10–19.45, 0.04; 2.59, 1.57–4.28; 4.06, 1.73–9.54; respectively). Conclusions: department often carries weight diagnosing disease. These highlight importance prehospital particularly screening palliative fostering multidisciplinary collaboration oncologists, geriatricians, specialists improve

Язык: Английский

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The current state and future direction of childcare for cancer patients: a narrative review

Supportive Care in Cancer, Год журнала: 2025, Номер 33(2)

Опубликована: Янв. 30, 2025

Abstract Purpose One in four patients diagnosed with cancer are parents to dependent children. For these patients, childcare services needed overcome the time demands of treatment. Despite support needs and its potential impact on treatment outcomes, targeted for remain limited. This review highlights state strategies address current chasm cancer. Methods A comprehensive search PubMed, Google Scholar, Embase was conducted 77 studies English Language Childcare published between January 1990 May 2024 were identified reviewed. Findings. The burden diagnosis imposes physical, psychological, financial, constraints young dependents. Many children miss appointments encounter delays due challenges childcare. Limited access is further exacerbated by financial toxicities unconventional such as emergency department visits, fatigue, other complications So far, only one cancer-center-linked program exists U.S., highlighting scale unmet need patients. Conclusion relevance. Providing non-traditional services, home-based or hospital-based structures, assistance through medical institutions, professional organizations, insurance payers, government-funded programs could bridge gap a diagnosis.

Язык: Английский

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Palliative patients who may benefit from intranasal delivery of symptomatic drugs: a two-center observational study evaluated the administration of morphine and dexamethasone in Polish hospices

Supportive Care in Cancer, Год журнала: 2025, Номер 33(2)

Опубликована: Фев. 1, 2025

Patients receiving hospice care at the end of life often suffer from a variety ailments. They may need medication to alleviate symptoms for rest their lives. The most common and recommended way take opioids steroids is orally. Less frequently, subcutaneous or intravenous routes are used. intranasal route relatively uncommon but interesting alternative administering drugs. study aims identify patients who benefit changing standard opioid steroid administration delivery. electronic medical records all home inpatient (both rural urban) were analyzed between February April 2024. focused on magnitude type problems associated with taking medications via assessed potential an administration. prescribed morphine, dexamethasone, both during co-administration included in analysis. Of 282 over period, 95 met inclusion criteria (33.7%). According researcher's original survey 87% experienced issues through route. Among related oral medicines, consciousness disorders significant 66%. For administration, main reluctance inject 19% lack cooperation caregivers 20%. profile patient symptomatic drugs includes impaired consciousness, aversion injections, administer injections by caregivers.

Язык: Английский

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