Complications of treatment in Oncology

Question 1

What are the complications of chemotherapy?

Answer 1

Anaemia and Neutropenic Sepsis.

Chemotherapy can also cause bone marrow suppression.

Question 2

What is defined as Neutropenic sepsis?

Answer 2

1. Temperature >38 on a single reading or >37.5 on 2 readings over 1 hour
2. Unexplained Low BP and Tachycardia
3. Neutrophil count of <1.0 x 10^9/L

Question 3

What leads to tumour lysis syndrome?

Answer 3

When large amounts of tumour cells are lysed.

Question 4

What are the 4 metabolic abnormalities that occur in Tumour Lysis Syndrome?

Answer 4

1. Hyperkalaemia
2. Hyperphosphataemia
3. Hyperuricaemia
4. Hypocalcaemia

Question 5

How does hyperphosphataemia leads to AKI?

Answer 5

Hyperphosphataemia forms calcium phosphate crystals which deposits in kidneys, leading to AKI

Question 6

What are the serious outcomes of Tumour Lysis Syndrome?

Answer 6

1. Uric acid nephropathy
2. Acute Kidney Failure
3. Seizures
4. Cardiac arrhythmias
5. Death

Question 7

How will giving Allopurinol and Rasburicase help in Tumour Lysis Syndrome?

Answer 7

Allopurinol prevents the formation of uric acid.

Rasburicase (a synthetic urate oxidase enzyme) wash out excessive uric acid crystals.