在急性白血病重症监护管理中的重要考虑因素
Hoda Pourhassan1, Waasil Kareem1, Vaibhav Agrawal1
1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA.
Journal of intensive care medicine
|November 22, 2023
概括
急性白血病会出现疾病和治疗的并发症,包括瘤溶解综合征和血栓形成. 管理策略对于解决这些危及生命的问题和新疗法毒性至关重要.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 内部医学 内部医学
背景情况:
- 急性白血病是一种严重的血液学疾病,具有显著的并发症.
- 这些并发症来自于疾病本身及其治疗方法,包括抗瘤疗法.
- 管理这些新出现的问题对于患者的治疗结果至关重要.
研究的目的:
- 审查急性白血病相关并发症的范围.
- 讨论这些并发症的潜在病理.
- 为临床医生提供管理建议.
主要方法:
- 关于急性白血病并发症的文献综述.
- 分析与白血病细胞负担和治疗不良事件有关的病理学.
- 综合当前的管理策略和新出现的毒性.
主要成果:
- 并发症包括瘤溶解综合征,超白细胞症,白细胞静止,分化综合征,毛细血管泄漏综合征和血栓事件.
- 对于L-阿斯巴拉金酶和恶性瘤相关的血栓形成,存在重大担忧.
- 患者免疫力低下,增加了败血症风险;像CAR T细胞这样的新疗法引入了新的毒性.
结论:
- 治疗急性白血病需要处理多样化和严重的并发症.
- 了解这些并发症的病理是有效干预的关键.
- 目前和新出现的毒性需要更新的临床指导和管理方法.
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