Adverse Events of Novel Therapies for Hematologic Malignancies: What Emergency Physicians Should Know

Mohsin Shah, Eva Rajha, Courtney DiNardo, Erin Muckey, William G. Wierda, Sai Ching J. Yeung

Research output: Contribution to journalReview article

Abstract

In the past decade, rapid advances in therapeutic target discovery in hematologic malignancies have led to many clinical studies demonstrating efficacy of novel agents. Between 2014 and 2018, Food and Drug Administration approvals of new drugs and agents have increased, with greater than 2 dozen novel agents. Rapidly identifying the risk profiles of these cancer therapeutics that may present with acute toxicities and understanding the timing, sequence, duration, and treatment of disease processes are the most important challenges faced by practitioners in emergency medicine, even in nononcologic centers. The emergency medicine literature lags behind rapid advances in oncology, and guidelines for rapid recognition and management of these emerging entities are not familiar. In this Review Article, we discuss the most recent and clinically relevant developments in the arena of hematologic malignancies, further expanding on drug toxicities and their clinical presentations and offering suggestions for management. Specifically, we discuss immune-related adverse events after immune checkpoint inhibitor therapy (including myocarditis and hemophagocytic lymphohistiocytosis), chimeric antigen receptor-T cell therapy, cytokine release syndrome, chimeric antigen receptor-T cell–related encephalopathy syndrome, differentiation syndrome, sinusoid occlusion syndrome, QT-interval prolongation, and tumor lysis syndrome. Rapid advances in hematology and oncology will bring many new challenges for emergency health care providers in the near future; thus, the urgency to raise awareness among this community.

Original languageEnglish (US)
Pages (from-to)264-286
Number of pages23
JournalAnnals of emergency medicine
Volume75
Issue number2
DOIs
StatePublished - Feb 2020

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Hematologic Neoplasms
Emergencies
Physicians
Antigen Receptors
Emergency Medicine
Tumor Lysis Syndrome
Hemophagocytic Lymphohistiocytosis
Drug Approval
Myocarditis
Brain Diseases
Emergency Medical Services
Hematology
Therapeutics
Cell- and Tissue-Based Therapy
Drug-Related Side Effects and Adverse Reactions
Health Personnel
Guidelines
Cytokines
Neoplasms

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Adverse Events of Novel Therapies for Hematologic Malignancies : What Emergency Physicians Should Know. / Shah, Mohsin; Rajha, Eva; DiNardo, Courtney; Muckey, Erin; Wierda, William G.; Yeung, Sai Ching J.

In: Annals of emergency medicine, Vol. 75, No. 2, 02.2020, p. 264-286.

Research output: Contribution to journalReview article

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