Review of Hematological and Oncological Emergencies
Stephanie Barré1, Jessica McElwee, Chara Calhoun
1Ochsner Louisiana State University Health, Shreveport (Dr Barré); Atrium Health's Carolinas Medical Center, Charlotte, North Carolina (Dr McElwee); Medical University of South Carolina, Charleston (Drs Calhoun, Maldonado, and Bell); and Department of Clinical Pharmacy and Outcome Sciences, University of South Carolina College of Pharmacy, Columbia (Dr Weant).
Abstract:
Patients with hematological malignancies, both treated and untreated, or solid tumors undergoing treatment are at risk of life-threatening complications, which may present in the emergency department (ED). Such emergencies are diverse in etiology and often require prompt treatment. Traditional complications, such as febrile neutropenia, have had recent guideline updates, which incorporate new evidence and a new validated risk stratification tool. In addition, newer approaches to treatment, such as chimeric antigen receptor (CAR) T-cell therapy, are becoming more widely available and have unique associated toxicities. This review discusses the management of the following hematological and oncological emergencies likely to be encountered in the ED: febrile neutropenia, CAR T-cell toxicities, differentiation syndrome, tumor lysis syndrome, hypercalcemia of malignancy, and hyponatremia.
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