Common acute oncological emergencies: Diagnosis, investigation and management

Postgraduate Medical Journal

Volumn 84, Issue 994, 2008, Pages 418-427

  Walji, N ^a   Chan, A K ^a   Peake, D R ^a  

^a QUEEN ELIZABETH HOSPITAL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

AMINOGLYCOSIDE ANTIBIOTIC AGENT; ANTIBIOTIC AGENT; ANTIFUNGAL AGENT; BISPHOSPHONIC ACID DERIVATIVE; CORTICOSTEROID; DEXAMETHASONE; GRANULOCYTE COLONY STIMULATING FACTOR; GRANULOCYTE MACROPHAGE COLONY STIMULATING FACTOR; PAMIDRONIC ACID; PENICILLIN G; QUINOLINE DERIVED ANTIINFECTIVE AGENT; RECOMBINANT GRANULOCYTE COLONY STIMULATING FACTOR; VANCOMYCIN; ZOLEDRONIC ACID;

ABNORMALLY HIGH SUBSTRATE CONCENTRATION IN BLOOD; ADD ON THERAPY; ANTIBIOTIC THERAPY; BACTEREMIA; BACTERIAL INFECTION; CANCER CHEMOTHERAPY; CLINICAL FEATURE; CLINICAL TRIAL; DRUG CLEARANCE; DRUG HALF LIFE; DRUG MEGADOSE; EMERGENCY CARE; FEBRILE NEUTROPENIA; FLUID RESUSCITATION; HUMAN; HYPERCALCEMIA; NUCLEAR MAGNETIC RESONANCE IMAGING; OXYGEN THERAPY; REVIEW; SEPSIS; SPINAL CORD COMPRESSION; SPINAL CORD DECOMPRESSION; STENT; SUPERIOR CAVA VEIN OBSTRUCTION;

EMERGENCIES; EMERGENCY TREATMENT; HEMATOPOIETIC CELL GROWTH FACTORS; HUMANS; HYPERCALCEMIA; NEOPLASMS; NEUTROPENIA; SUPERIOR VENA CAVA SYNDROME;

EID: 53649110578     PISSN: 00325473     EISSN: None     Source Type: Journal    
DOI: 10.1136/pgmj.2007.067033     Document Type: Review

References (81)

1. Cancer Research UK, Cancer statistics. www.cancerresearchuk.org
2. Robton KV, The Infectious Diseases Society of America 2002 Guidelines for the use of antimicrobial agents in patients with cancer and neutropenia: salient features and comments. Clin Meet Dis 2004;39(suppl 1):S44-8.
3. Schimpff SC, Empiric antibiotic therapy for granulocytopenic cancer patients. Am J Med 1986;80:13-20.
4. Bodey GP, Buckley M, Sathe YS. et al. Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med 196;64:32S-40.
5. st century. Cancer 2005;103:1103-13.
6. Bodey GP, Unusual presentations of infection in neutropenic patients. Int J Antimicrob Agents 2000;16:93-5.
7. Middleman EL, Watanabe A, Kaizer H, et al. Antibiotic combinations for infections in neutropenic patients. Evaluated of carbenicillin plus either cephalothm or kanamycin Cancer 1972;30:573-9.
8. Schimpff S, Satterlee W, Young VM, et al. Empiric therapy with carbenicillin and gentamicin for febrile patients with cancer and granulocytopenia. N Engl J Med 1971;284:1061-5.
9. McCabe WR, Jackson GG. Gram-negative bacteremia II. Clinical, laboratory and therapeutic observations. Arch Intern Med 1962;110:856-64.
10. Bodey GP, Rodriguez V. Chang HY, et al. Fever and infection in leukemic patients: a study of 494 consecutive patients. Cancer 1978;41:1610-22.
11. The EORTC International Antimicrobial Therapy Cooperative Group. Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia. N Engl J Med 1987;317:1692-8.
12. Zinner SH, Changing epidemiology of infections in patients with neutropenia and cancer: emphasis on gram-positive and resistant bacteria. Clin Infect Dis 1999;29:490-4.
13. Wisplinghoff H, Seifert H. Wenzel RP. et al. Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematologol malignancies and solid neoplasms in hospitals in the United States. Clin Infect Dis 2003;36:1103-10.
14. Viscoli C, Castagnola E. Treatment of febrile neutropenia: what is new? Curr Opin Infect Dis 2002;15:377-82.
15. Cordonnier C, Buzyn A, Leverger G, et al. Epidemiology and risk factors for grampositive coccal infections in neutropenia: toward a more targeted antibiotic strategy Clin Infect Dis 2003;36:149-58.
16. Souza LM, Boone TC, Gabrilove J, et al. Recombinant human granulocyte colonystimulating factor: effects on normal and leukemic myeloid cells. Science 1986;232:61-5.
17. Ozer H, Armitage JO. Bennett CL, et al. American Society of Clinical Oncology 2000 update of recommendations for the use of hematopoietic colony-stimulating factors: evidence-based, clinical practice guidelines. American Society of Clinical Oncology Growth Factors Expert Panel. J Clin Oncol 2000;18:3558-85.
18. Vogel CL, Wojtukiewicz MZ, Carroll RR, et al. First and subsequent cycle use of pegfilgrastim prevents febrile neutropenia in patients with breast cancer: a multicenter, double-blind, placebo-controlled phase III study. J Clin Oncol 2005;23:1178-84.
19. Timmer-Bonte JN, de Boo TM, Smit HJ, et al. Prevention of chemotherapy-induced febrile neutropenia by prophylactic antibiotics plus or minus granulocyte colonystimulating factor in small-cell lung cancer: a Dutch Randomized Phase III Study. J Clin Oncol 2005;23:7974-84.
20. Smith TJ, Khatcheressian J, Lyman GH, et al. 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol 2006;24:3187-205.
21. Molineux G, Pegfilgrastim: using pegylation technology to improve neutropenia support in cancer patients. Anticancer Drugs 2003;14:259-64.
22. Arshad M, Setter K. Bilaniuk J, et al. Side effects related to cancer treatment: case 2. Splenic rupture following pegfilgrastim. J Clin Oncol 2005;23:8533-4.
23. Hughes WT, Armstrong D, Bodey GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002;34:730-51.
24. Gafter-Gvili A, Fraser A. Paul M, et al. Meta-analysis: antibiotic prophylaxis reduces mortality in neutropenic patients. Ann Intern Med 2005;142:979-95.
25. Quinn JA, DeAngelis LM. Neurological emergencies in the cancer patient. Semin Oncol 2000;27:311-21.
26. Klimo Jr P, Thompson CJ, Kestle JRW, et al. A meta-anafysis of surgery versus conventional radiotherapy for the treatment of metastatic epidural spinal disease Neuro-oncol 2005;7:64-76.
27. Bach F, Larsen BH, Rohde K, et al. Metaststic spinal cord compression. Occurrence, symptoms, clinical presentations and prognosis in 398 patients with spinal cord compression. Acta Neurochir (Wien) 1990;107:37-43.
28. Bucholtz JD, Metastatic epidural spinal cord compression. Semin Oncol Nurs 1999;15:150-9.
29. Loblaw DA, Laperriere NJ. Mackillop WJ. A population-based study of malignant spinal cord compression in Ontario. Clin Oncol (R Coll Radiol) 2003;15:211-7.
30. Levack P, Graham J, Collie D, et al. Don't wait for a sensory level - listen to the symptoms: a prospective audit of the delays in diagnosis of malignant cord compression. Clin Oncol (R Coll Radiol) 2002;14:472-80.
31. Husband DJ, Malignant spinal cord compression: prospective study of delays in referral and treatment. BMJ 1998;317:18-21.
32. Jacobs WB, Perrin RG. Evaluation and treatment of spinal metastases: an overview. Neurosurg Focus 2001;11:e10.
33. Husband DJ, Grant KA, Romaniuk CS. MRI in the diagnosis and treatment of suspected malignant spinal cord compression. Br J Radiol 2001;74:15-23.
34. Loblaw DA, Laperriere N, Perry J, et al. Malignant extradural spinal cord compression: diagnosis and management. Evidence summary report #9-9. http://www.cancercare.on.ca
35. Carmody RF, Yang PJ, Seeley GW, et al. Spinal cord compression due to metastatic disease: diagnosis with MR imaging versus myelography. Radiol 1989;173:225-9.
36. Hagenau C, Grosh W, Currie M, et al. Comparison of spinal magnetic resonance imaging and myelography in cancer patients. J Clin Oncol 1987;5:1663-9.
37. Sorensen PS, Helweg-Larsen S, Mouridsen H, et al. Effect of high-dose dexamethasone in carcinomatous metastatic spinal cord compression treated with radiotherapy: a randomized trial. EurJ Cancer 1994;30A:22-7.
38. Rades D, Veninga T, Stalpers LJA, et al. Outcome after radiotherapy alone for metastatic spinal cord compression in patients with oligometastases. J Clin Oncol 2007;25:50-6.
39. Young RF, Post EM, King GA. Treatment of spinal epidural metastases: randomized prospective comparison of laminectomy and radiotherapy. J Neurosurg 1980;53:741-8.
40. Sorensen PS, Borgesen SE, Rhode K. Metastatic epidural spinal cord compression. Results of treatment and survival. Cancer 1990;65:1502-8.
41. Patchell RA, Tibbs PA, Regine WF, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomized trial. Lancet 2005;366:643-8.
42. Maranzano E, Latini P. Effectiveness of radiation therapy without surgery in metastatic spinal cord compression: final results from a prospective trial. Int J Radiat Oncol Biol Phys 1995;32:959-67.
43. Rades D, Fehlauer F, Hartmann A, et al. Reducing the overall treatment time for radiotherapy of metastatic spinal cord compression (MSCC): 3-year results of a prospective observational multi-center study. J Neuro Oncol 2004;70:77-82.
44. Rades D, Karstens JH. A comparison of two different radiation schedules for metastatic spinal cord compression considering a new prognostic factor. Strahlenther Onkol 2002;178:556-61.
45. Rades D, Blach M, Bremer M, et al. Prognostic significance of the time of developing motor deficits before radiation therapy in metastatic spinal cord compression: oneyear results of a prospective trial. Int J Radiat Oncol Biol Phys 2000;48:1403-8.
46. Helweg-Larsen S, Soelberg-Sorensen P, Kreiner S. Prognostic factors in metastatic spinal cord compression: a prospective study using multivariate analysis of variables influencing survival and gait function in 153 patients. Int J Radiat Oncol Biol Phys 2000;46:1163-9.
47. Kim HJ, Kim HS, Chung SH. CT diagnosis of superior vena cava syndrome: importance of collateral vessels. AJR Am J Roentgenol 1993;161:539-42.
48. Parish JM, Marschke RF, Dines DE, et al. Etiologic considerations in superior vena cava syndrome. Mayo Clin Proc 1981;56:407.
49. Ostler PJ, Clarke DP, Watkinson AF, et al. Superior vena cava obstruction: a modern management strategy. Clin Oncol 1997;9:83-9.
50. Armstrong BA, Perez CA, Simpson JR, et al. Role of irradiation in the management of superior vena cava syndrome. Int J Radiat Oncol Biol Phys 1987;13:531-9.
51. Salsali M, Cliffton EE. Superior vena caval obstruction in carcinoma of lung. N Y State J Med 1969;69:2875-80.
52. Wilson LD, Detterbeck FC, Yahalom J. Superior vena cava syndrome with malignant causes. N Engl J Med 2007;356:1862-9.
53. Rowell NP, Gleeson FV. Steroids, radiotherapy, chemotherapy and stents for superior vena caval obstruction in carcinoma of the bronchus: a systematic review. Clin Oncol 2002;14:338-51.
54. Ahmann FR, A reassessment of the clinical implications of the superior vena cavai syndrome. J Clin Oncol 1984;2:961-9.
55. Loeffler JS, Leopold KA, Recht A, et al. Emergency prebiopsy radiation for mediastinal masses: impact on subsequent pathologic diagnosis and outcome. J Clin Oncol 1986;4:716-21.
56. Couban S, Goodyear M, Burnell M, et al. Randomized placebo-controlled study of low-dose warfarin for the prevention of central venous catheter-associated thrombosis in patients with cancer. J Clin Oncol 2005;23:4063-9.
57. Kirkpatrick A, Rathbun S, Whitsett T, et al. Prevention of central venous catheterassociated thrombosis: a meta-analysis. Am J Med 2007;120:901e1-13.
58. Akl EA, Karmath G, Yousico V, et al. Anticoagulation for thrombosis prophylaxis in cancer patients with central venous catheters. Cochrane Database of Systematic Reviews 2007, Issue 3. CD006468.
59. Agus ZS, Aetiology of hypercalcaemia. http://www.utdol.com
60. Farr HW, Fahey TJ Jr, Nash AG, et al. Primary hyperparathyroidism and cancer. Am J Surg 1973;126:539-43.
61. Dirix LY, van Oosterom AT. Metabolic complications. Oxford textbook of oncology, 2nd ed. Oxford University Press, 2002.
62. Stewart AF, Hypercalcaemia associated with cancer. N Engl J Med 2005;352:373-9.
63. Hosking DJ, Cowley A, Bucknall CA. Rehydration in the treatment of severe hypercalcaemia. QJM 1981;50:473-81.
64. Kearney T, Dang C. Diabetic and endocrine emergencies. Postgrad Med J 2007;83:79-86.
65. Green JR, Preclinical pharmacology of zoledronic acid. Semin Oncol 2002;6(supplement 21):3-11.
66. Clezardin P, The antitumour potential of bisphosphonates. Semin Oncol 2002;6(supplement 21):33-42.
67. Singer FR, Ritch PS, Lad TE, et al. Treatment of hypercalcaemia of malignancy with intravenous etidronate. A controlled multicentre study. The hypercalcaemia study group. Arch Intern Med 1991;151:471-6.
68. O'Rouke NP, McCloskey EV, Vasikaran S, et al. Effective treatment of malignant hypercalcaemia with a single intravenous infusion of clodronate. Br J Cancer 1993;67:560-3.
69. Gucalp R, Theriault R, Gill I, et al. Treatment of cancer-associated hypercalcaemia. Double blind comparison of rapid and slow intravenous infusion regimens of pamidronate disodium and saline alone. Arch Intern Med 1994;154:1935-44.
70. Saunders Y, Ross JR, Broadley KE, et al. Systematic review of bisphosphonates for hypercalcaemia of malignancy. Palliat Med 2004;18:418-31.
71. Gucalp R, Ritch P, Wiernik PH, et al. Comparative study of pamidronate disodium and etidronate disodium in the treatment of cancer related hypercalcaemia. J Clin Oncol 1992;10:134-42.
72. Nussbaum SR, Younger J, Vandepol CJ, et al. Single-dose intravenous therapy for the treatment of hypercalcaemia of malignancy: comparison of 30-, 60-, and 90-mg dosages. Am J Med 1993;95:297- 304.
73. Major P, Lortholary A, Hon J, et al. Zoledronic acid is superior to pamidronate in the treatment of hypercalcaemia of malignancy: a pooled analysis of two randomized controlled clinical trials. J Clin Oncol 2001;19:558-67.
74. Fleisch H, Bisphosphonates: mechanisms of action. Endocr Rev 1998;19:80-100.
75. Gurney H, Grill V, Martin TJ. Parathyroid hormone-related protein and response to pamidronate in tumour induced hypercalcaemia. Lancet 1993;341:1611-13.
76. Wimalawansa SJ, Significance of plasma PTH-rp in patients with hypercalcaemia of malignancy treated with bisphosphonate. Cancer 1994;73:2223-30.
77. Warrell RP Jr, Israel R, Frisone M, et al. Gallium nitrate for acute treatment of cancer-related hypercalcaemia. A randomized, double blind comparison to calcitonin. Ann Intern Med 1988;108:69-74.
78. Warrell RP Jr, Murphy WK, Schulman P, et al. A randomized double-blind study of gallium nitrate compared with etidronate for acute control of cancer-related hypercalcaemia. J Clin Oncol 1991;9:1467-75.
79. Gratters JC, Hermus AR, de Mulder PH, et al. Long-term follow up of breast cancer patients treated for hypercalcaemia with aminohydroxypropylidene bisphosphate. Breast Cancer Res Treat 1993;25:277-81.
80. Pecherstorfer M, Schilling T, Blind E, et al. Parathyroid hormone-related protein and life expectancy in hypercalcaemic cancer patients. J Clin Endocrinol Metab 1994;78:1268-70.
81. Ling PJ, A'Hern RP, Hardy JR. Analysis of survival following treatment of tumourinduced hypercalcaemia with intravenous pamidronate (APD). Br J Cancer 1995;72:206-9.