Oncologic therapy related adverse events

Clinical Features

• Many novel oncologic therapies and Biologic immunomodulators adverse reactions may mimic common ED presentations such as sepsis.

Types of novel oncologic agents

• Genetically engineered T cells
  • CD19–chimeric antigen receptor (CAR)-T cell therapy
• Monoclonal Antibodies against PD-1 checkpoints
• Small-molecule inhibitors
• Antibody-drug conjugates
• Immunotoxins
• Bispecific T-cell engagers

Differential Diagnosis

• Decreased cellular immunity which an cause reactivation or new
  • Tuberculosis
  • Sepsis
  • Fungal infections
  • Hepatitis B
• Neurologic syndromes
  • Multiple sclerosis
  • Seizures
  • Guillain-Barre syndrome
• Hematologic side effects
  • Aplastic anemia
  • Pancytopenia
• Cardiac effects
  • Congestive heart failure
  • Arrhythmias
• Allergic reactions
• Pulmonary
  • Pneumonia
  • Pneumocystis jirovecii pneumonia
  • Pneumonitis
• Endocrine
  • Thyroiditis
• GI
  • Perforations
  • Clostridium difficile
  • Acute bacterial infections
• Malignancies
  • Non-melanoma skin cancers
  • Lymphoma

CAR-T cells medications

Axicabtagene ciloleucel (Yescarta)

• Indications: Acute lymphoblastic leukemia and Large B-cell lymphoma

See Also

• Biologic immunomodulators