Note: Page numbers of article titles are in boldface type. A Abdominal radiotherapy, toxic effects of, 636 637 Acute promyelocytic leukemia, associated with acquired bleeding problems, 614 615 Acute renal failure. See Renal complications. Adjunct therapies, for cerebral edema and increased cranial pressure in cancer patients, 519 Adjuvant analgesics, with opioid therapy for cancer pain, 651 652 Adrenal infarction, special issues in cancer patients, 495 Aminoglycosides, acute renal failure in cancer patients due to, 571 572 Amphotericin B, acute renal failure in cancer patients due to, 572 Analgesia. See Pain. Angiography, computed tomographic (CTA), for pulmonary embolism diagnosis, 490 Anticoagulation, in cancer patients with thrombocytopenia, 494 Antiplatelet agents, acquired bleeding problems in cancer patients caused by, 616 Antithrombotic therapy, acquired bleeding problems in cancer patients due to complications of, 616 618 antiplatelet agents, 616 fibrinolytic agents, 618 heparin, 617 618 new agents, 618 warfarin, 616 617 Apoplexy, pituitary, acute stroke in cancer patients due to, 525 Azotemia, renal complications in cancer patients, 567 575 epidemiology, 567 568 management, 573 postrenal, 572 573 extrarenal obstruction, 572 573 intrarenal obstruction, 573 prerenal, 568 renal, 568 572 complications due to bone marrow transplant, 572 contrast agent nephropathy, 572 malignant infiltration, 568 nephrotoxic drugs, 571 572 tumor lysis syndrome, 568 571 B Bleeding problems, acquired, in cancer patients, 603 624 approach to, 603 605 laboratories, 603 605 patient review, 603 Hematol Oncol Clin N Am 24 (2010) 659 668 doi:10.1016/s0889-8588(10)00073-0 hemonc.theclinics.com 0889-8588/10/$ see front matter ª 2010 Elsevier Inc. All rights reserved.
660 Bleeding (continued) coagulation factor-related bleeding, 607 608 acquired factor VIII inhibitors, 607 acquired von Willebrand disease, 607 disseminated intravascular coagulation, 607 608 complications of antithrombotic therapy, 616 618 antiplatelet agents, 616 fibrinolytic agents, 618 heparin, 617 618 new agents, 618 warfarin, 616 617 massive transfusion therapy, 605 607 complications of, 606 recombinant factor VIIa, 606 607 platelet numbers and function, 608 614 drug-induced hemolytic disseminated intravascular coagulation syndromes, 612 613 drug-induced thrombocytopenia, 608 heparin-induced thrombocytopenia, 610 immune thrombocytopenia, 608 in the platelet refractory patient, 608 609 post-transfusion thrombocytopenia, 608 therapy-related TTP/hemolytic uremic syndrome, 611 612 thrombotic thrombocytopenic purpura, 610 611 uremia, 613 specific hematological cancers associated with, 614 616 acute promyelocytic leukemia, 614 615 dysproteinemias, 615 616 myeloproliferative syndromes, 615 other leukemias and myelodysplastic syndromes, 615 Bone marrow transplant, nephropathy in cancer patients due to complications of, 572 Brain tumors, thrombosis in patients with primary or metastases, 493 494 Budd-Chiari syndrome, special issues in cancer patients, 495 C Cancer, emergencies related to, 487 658 acquired bleeding problems, 603 624 cancer-related pain, 643 658 electrolyte complications of malignancy, 553 565 malignant epidural spinal cord compression, 537 551 myeloproliferative disorders and hyperviscosity syndrome, 585 602 neurologic, 515 535 acute stroke, 523 525 altered mental status, 519 521 cerebral edema and increased intracranial pressure, 516 519 leptomeningeal metastases, 525 527 paraneoplastic neurologic syndromes, 527 530 seizures, 521 523 neutropenic enterocolitis, 577 584 radiation therapy-related toxicity, 625 642 renal complications, 567 575
661 superior vena cava syndrome, 501 513 venous thrombotic, 487 500 Cardiac toxicity, radiation therapy-related, 638 Central nervous system toxicity, radiation therapy-related, 632 634 Cerebral edema, and increased cranial pressure in cancer patients, 516 529 adjunct therapies, 519 corticosteroids, 517 519 hyperventilation, 519 osmotherapy, 519 Cerebral metastases, hemorrhagic, acute stroke in cancer patients due to, 525 Cerebral vein thrombosis, special issues in cancer patients, 494 495 Chemotherapy, agents implicated in neutropenic enterocolitis, 578 579 for superior vena cava syndrome in cancer patients, 507 Coagulation factor-related bleeding, acquired, in cancer patients, 607 608 acquired factor VIII inhibitors, 607 acquired von Willebrand disease, 607 disseminated intravascular coagulation, 607 608 Computed tomography (CT), CT angiography (CTA), for pulmonary embolism diagnosis, 490 diagnostic, in neutropenic enterocolitis, 580 581 Constipation, prophylaxis against, with opioid therapy for cancer pain, 654 Contrast agents, nephropathy in cancer patients due to, 572 Corticosteroids, for cerebral edema and increased cranial pressure in cancer patients, 517 519 for malignant epidural spinal cord compression, 541 Cross-tolerance, in opioid therapy for cancer pain, 650 Cyclosporine, acute renal failure in cancer patients due to, 571 D D-dimer assays, for pulmonary embolism/deep vein thrombosis, 488 490 Deep vein thrombosis, in cancer patients, 487 493 diagnostic tests, 488 490 duration and choice of therapy, 493 immediate therapy, 490 493 natural history, 487 pathophysiology, 487 488 Delirium, in cancer patients, 519 521 Disseminated intravascular coagulation, bleeding in cancer patients due to, 607 608 drug-induced hemolytic, bleeding problems in cancer patients due to, 613 614 Doppler ultrasound, for deep vein thrombosis diagnosis, 490 Double effect, with opioid therapy for cancer pain, 649 Drug-induced hemolytic disseminated intravascular coagulation syndrome, bleeding problems in cancer patients due to, 613 614 Drug-induced thrombocytopenia, bleeding problems in cancer patients due to, 609 Drugs, nephrotoxic, acute renal failure in cancer patients due to, 571 572 aminoglycosides, 571 572 cyclosporine, 571 tacrolimus, 571 opioid therapy for cancer-related pain, 646 656 Dysproteinemias, acquired bleeding problems associated with, 615 616
662 E Electrolyte complications, of malignancy, 553 565 hypercalcemia, 558 562 hypoglycemia of malignancy, 557 558 hypomagnesemia, 562 563 hyponatremia, 553 555 hypophosphatemia, 563 osmotic demyelination syndrome, 555 557 Emboli, pulmonary, in cancer patients, 487 493 septic, acute stroke in cancer patients due to, 525 tumor, acute stroke in cancer patients due to, 524 525 Emergencies, cancer-related, 487 658 acquired bleeding problems, 603 624 cancer-related pain, 643 658 electrolyte complications of malignancy, 553 565 malignant epidural spinal cord compression, 537 551 myeloproliferative disorders and hyperviscosity syndrome, 585 602 neurologic, 515 535 acute stroke, 523 525 altered mental status, 519 521 cerebral edema and increased intracranial pressure, 516 519 leptomeningeal metastases, 525 527 paraneoplastic neurologic syndromes, 527 530 seizures, 521 523 neutropenic enterocolitis, 577 584 radiation therapy-related toxicity, 625 642 renal complications, 567 575 superior vena cava syndrome, 501 513 venous thrombotic, 487 500 Endarteritis, radiation therapy-related, 638 Endobronchial ultrasound-guided biopsy, superior vena cava syndrome in cancer patients, 503 504 Endocarditis, nonbacterial thrombotic, acute stroke in cancer patients due to, 523 524 Endovascular stenting, for superior vena cava syndrome in cancer patients, 507 508 Enterocolitis, neutropenic, in cancer patients, 577 584 background and state of the evidence, 577 578 clinical presentation and risk factors, 578 580 medical vs. surgical treatment, 581 583 role of diagnostic imaging, 580 581 Epidural spinal cord compression, malignant. See Spinal cord compression. Erythrocytosis, in cancer patients, 589 591 F Factor VIII inhibitors, acquired, bleeding in cancer patients due to, 607 Fibrinolytic agents, acquired bleeding problems in cancer patients caused by, 618 Fibrosis, radiation therapy-related toxicity, 627 H Head and neck cancer, radiation therapy-related toxicity, 634 636
663 Hematological cancers, associated with acquired bleeding problems in patients with, 614 616 dysproteinemias, 615 616 myeloproliferative syndromes, 615 other leukemias and myelodysplastic syndromes, 615 Hemolytic-uremic syndrome, bleeding problems in cancer patients due to thrombotic thrombocytopenic purpura and, 612 613 Hemorrhagic cerebral metastases, acute stroke in cancer patients due to, 525 Heparin, acquired bleeding problems in cancer patients caused by, 617 618 low-molecular-weight, for pulmonary embolism/deep vein thrombosis in cancer patients, 492 493 Heparin-induced thrombocytopenia, bleeding problems in cancer patients due to, 611 Hypercalcemia, in cancer patients, 558 562 Hyperleukocytosis, in cancer patients, 591 594 Hyperventilation, for cerebral edema and increased cranial pressure in cancer patients, 519 Hyperviscosity syndrome, myeloproliferative disorders and, 585 602 related to hyperproteinemia, 586 589 Hypoglycemia of malignancy, 557 558 Hypomagnesemia, in cancer patients, 562 563 Hyponatremia, in cancer patients, 553 555 Hypophosphatemia, in cancer patients, 563 I Imaging studies, diagnostic, in neutropenic enterocolitis, 580 581 superior vena cava syndrome in cancer patients, 503 504 Immune thrombocytopenia, bleeding problems in cancer patients due to, 609 Infiltration, malignant, acute renal failure in cancer patients due to, 568 Intracranial pressure, increased, and cerebral edema in cancer patients, 516 529 K Kidneys. See Renal complications. Kyphoplasty, percutaneous, for malignant epidural spinal cord compression, 547 L Leptomeningeal metastases, in cancer patients, 525 527 Leukemia, acute promyelocytic, acquired bleeding problems associated with, 614 615 pediatric, neutropenic enterocolitis as complication of, 577 578 Low-molecular-weight heparin, for pulmonary embolism/deep vein thrombosis in cancer patients, 492 493 Lung cancer, superior vena cava syndrome in patients with, 501 513 Lymphoma, superior vena cava syndrome in patients with, 501 513 M Malignant epidural spinal cord compression. See Spinal cord compression. Malignant pain, assessment of, 643 645 Mental status, altered, in cancer patients, 519 521 delirium, 519 521 nonconvulsive status epilepticus, 521
664 Metastases, hemorrhagic cerebral, acute stroke in cancer patients due to, 525 leptomeningeal, in cancer patients, 525 527 Myelodysplastic syndromes, acquired bleeding problems associated with, 615 Myeloproliferative disorders, in cancer patients, 585 602 erythrocytosis and polycythemia vera, 589 591 hyperleukocytosis, 591 594 hyperviscosity syndrome related to hyperproteinemia, 586 589 thrombocytosis, 594 596 Myeloproliferative syndromes, acquired bleeding problems associated with, 615 N Naloxone, for reversal of opioid therapy for cancer pain, 649 Nephrotoxic drugs, acute renal failure in cancer patients due to, 571 572 aminoglycosides, 571 572 cyclosporine, 571 tacrolimus, 571 Neurologic emergencies, in cancer patients, 515 535 acute stroke, 523 525 altered mental status, 519 521 cerebral edema and increased intracranial pressure, 516 519 leptomeningeal metastases, 525 527 paraneoplastic neurologic syndromes, 527 530 seizures, 521 523 Neutropenic enterocolitis, in cancer patients, 577 584 background and state of the evidence, 577 578 clinical presentation and risk factors, 578 580 medical vs. surgical treatment, 581 583 role of diagnostic imaging, 580 581 Nonbacterial thrombotic endocarditis, acute stroke in cancer patients due to, 523 524 O Obstruction, postrenal azotemia in cancer patients due to, 572 573 extrarenal, 572 573 intrarenal, 573 Opioid therapy, for cancer-related pain, 646 656 adjuvant analgesics, 651 652 bolus effect, 651 breakthrough dosing, 651 cross-tolerance, 650 651 dosing strategies, 650 non-recommended opioids, 653 654 pharmacology, 646 648 prophylaxis against constipation, 654 655 rapid titration in the emergency department, 655 656 respiratory depression, naloxone, and double effect, 648 649 routes of administration, 652 653 side effects, 654 Osmotherapy, for cerebral edema and increased cranial pressure in cancer patients, 519 Osmotic demyelination syndrome, in cancer patients, 555 557
665 P Pain, cancer-related, 643 658 assessment of, 643 645 opioid therapy for, 646 656 adjuvant analgesics, 651 652 bolus effect, 651 breakthrough dosing, 651 cross-tolerance, 650 651 dosing strategies, 650 non-recommended opioids, 653 654 pharmacology, 646 648 prophylaxis against constipation, 654 655 rapid titration in the emergency department, 655 656 respiratory depression, naloxone, and double effect, 648 649 routes of administration, 652 653 side effects, 654 treatment strategies, 645 646 WHO stepladder for, 645 646 Paraneoplastic syndromes, neurologic, 527 530 Pelvic radiotherapy, toxic effects of, 636 637 Pituitary apoplexy, acute stroke in cancer patients due to, 525 Platelet number and function, acquired bleeding problems in cancer patients due to, 608 614 drug-induced hemolytic disseminated intravascular coagulation syndromes, 612 613 drug-induced thrombocytopenia, 608 heparin-induced thrombocytopenia, 610 immune thrombocytopenia, 608 in the platelet refractory patient, 608 609 post-transfusion thrombocytopenia, 608 therapy-related TTP/hemolytic uremic syndrome, 611 612 thrombotic thrombocytopenic purpura, 610 611 uremia, 613 Platelet refractory patients, bleeding problems in, 609 610 Pneumonitis, radiation therapy-related toxicity, 630 632 Polycythemia vera, in cancer patients, 589 591 Portal vein thrombosis, special issues in cancer patients, 496 Post-transfusion purpura, bleeding problems in cancer patients due to, 609 Postrenal azotemia, in cancer patients, 572 573 extrarenal obstruction, 572 573 intrarenal obstruction, 573 Prerenal azotemia, in cancer patients, 568 Promyelocytic leukemia, acute, acquired bleeding problems associated with, 614 615 Pulmonary embolism, in cancer patients, 487 493 diagnostic tests, 488 490 duration and choice of therapy, 493 immediate therapy, 490 493 natural history, 487 pathophysiology, 487 488 Pulmonary toxicity, radiation therapy-related, 630 632
666 R Radiation therapy, for superior vena cava syndrome in cancer patients, 506 507 palliative, for malignant epidural spinal cord compression, 541 542 radiobiological effects at the cellular and tissue level, 626 627 therapeutic mechanism of clinical, 625 626 toxicity related to, in cancer patients, 625 642 by organ system, 627 638 abdominal and pelvic, 636 637 cardiac, 637 central nervous system, 632 633 head and neck, 633 636 pulmonary, 630 632 skin and soft tissue, 627, 630 Recombinant factor VIIa, massive transfusion therapy for acquired bleeding problems in cancer patients, 606 607 Renal azotemia, in cancer patients, 568 572 complications due to bone marrow transplant, 572 contrast agent nephropathy, 572 malignant infiltration, 568 nephrotoxic drugs, 571 572 tumor lysis syndrome, 568 571 Renal complications, in cancer patients, 567 575 epidemiology, 567 568 management, 573 postrenal azotemia, 572 573 extrarenal obstruction, 572 573 intrarenal obstruction, 573 prerenal azotemia, 568 renal azotemia, 568 572 complications due to bone marrow transplant, 572 contrast agent nephropathy, 572 malignant infiltration, 568 nephrotoxic drugs, 571 572 tumor lysis syndrome, 568 571 Renal salt wasting, hyponatremia in cancer patients due to, 554 Renal vein thrombosis, special issues in cancer patients, 496 Respiratory depression, with opioid therapy for cancer pain, 648 649 S Seizures, in cancer patients, 521 523 Septic emboli, acute stroke in cancer patients due to, 525 Skin toxicity, radiation therapy-related, 627, 630 Soft tissue toxicity, radiation therapy-related, 627, 630 Spinal cord compression, malignant epidural, in cancer patients, 537 551 clinical presentation, 539 540 diagnosis, 540 epidemiology, 537 538 management, 540 547 corticosteroids, 541 emerging options, 546 547
667 palliative radiation therapy, 541 542 surgical decompression, 542 546 pathophysiology, 538 539 Spinal stereotactic radiosurgery, for malignant epidural spinal cord compression, 546 547 Status epilepticus, nonconvulsive, in cancer patients, 521 Stenting, endovascular, for superior vena cava syndrome in cancer patients, 507 508 Stroke, acute, in cancer patients, 523 525 hemorrhagic cerebral metastases, 525 nonbacterial thrombotic endocarditis, 523 524 pituitary apoplexy, 525 septic emboli, 525 therapy-induced, 524 tumor emboli, 524 525 Superior vena cava syndrome, in cancer patients, 501 513 anatomy and physiology, 501 502 evaluation, 503 504 diagnostic interventions, 504 imaging studies, 504 management, 504 508 chemotherapy, 507 endovascular stenting, 507 508 interventions for symptom relief, 505 506 radiation, 506 507 presentation, 502 503 recommendations, 508 510 Surgery, decompressive, for malignant epidural spinal cord compression, 542 546 versus medical treatment of neutropenic enterocolitis, 581 583 Syndrome of inappropriate antidiuretic hormone, hyponatremia in cancer patients due to, 554 T Tacrolimus, acute renal failure in cancer patients due to, 571 Therapy-induced stroke, in cancer patients, 524 Thrombocytopenia, bleeding problems in cancer patients due to, drug-induced, 609 heparin-induced, 611 immune, 609 Thrombocytosis, in cancer patients, 594 596 Thrombolytic therapy, for pulmonary embolism/deep vein thrombosis, 490 493 Thrombosis, emergencies in cancer patients, 487 500 pulmonary embolism/deep vein thrombosis, 487 493 diagnostic tests, 488 490 duration and choice of therapy, 493 immediate therapy, 490 493 natural history, 487 pathophysiology, 487 488 special issues in, 493 496 adrenal infarction, 495 anticoagulation and thrombocytopenia, 494 Budd-Chiari syndrome, 495 cerebral vein thrombosis, 494 495
668 Thrombosis (continued) patients with primary brain tumors or metastases, 493 494 portal vein thrombosis, 496 renal vein thrombosis, 496 upper extremity thrombosis, 494 visceral vein thrombosis, 496 Thrombotic endocarditis, nonbacterial, acute stroke in cancer patients due to, 523 524 Thrombotic thrombocytopenic purpura, bleeding problems in cancer patients due to, 611 612 hemolytic-uremic syndrome and, 612 613 Toxicity, radiation therapy-related, 625 642 Transfusion therapy, massive, for acquired bleeding problems in cancer patients, 605 607 complications of, 606 recombinant factor VIIa, 606 607 Tumor emboli, acute stroke in cancer patients due to, 524 525 Tumor lysis syndrome, acute renal failure in cancer patients due to, 568 571 U Ultrasound, diagnostic, in neutropenic enterocolitis, 580 581 Upper-extremity thrombosis, special issues in cancer patients, 494 Uremia, bleeding problems in cancer patients due to, 614 V Venous thrombotic emergencies, in cancer patients, 487 500 pulmonary embolism/deep vein thrombosis, 487 493 diagnostic tests, 488 490 duration and choice of therapy, 493 immediate therapy, 490 493 natural history, 487 pathophysiology, 487 488 special issues in, 493 496 adrenal infarction, 495 anticoagulation and thrombocytopenia, 494 Budd-Chiari syndrome, 495 cerebral vein, 494 495 patients with primary brain tumors or metastases, 493 494 portal vein, 496 renal vein, 496 upper extremity, 494 visceral vein, 496 Vertebroplasty, percutaneous, for malignant epidural spinal cord compression, 547 Visceral vein thrombosis, special issues in cancer patients, 496 W Waldenström macroglobulinemia, hyperviscosity syndrome due to, 586 589 Warfarin, acquired bleeding problems in cancer patients caused by, 616 617 for pulmonary embolism/deep vein thrombosis in cancer patients, 493 World Health Organization (WHO), stepladder for management of cancer pain, 645 646