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Oncologic Emergencies - Differential Diagnosis Framework

HEMATOLOGIC ONCOLOGIC EMERGENCIES:
Hyperviscosity Syndrome:
 • Spontaneous bleeding
 • Shortness of breath
Diagnosis Framework HEMATOLOGIC ... Hyperviscosity Syndrome ... • Spontaneous bleeding ... neutrophil count < 500 cells ... : Tumor Lysis Syndrome
Myelodysplastic Syndrome (MD) - Diagnosis and Management Summary
myelo (marrow) -dys- (abnormal) -plastic (shape) = funny-shaped cells
Myelodysplastic Syndrome ... = funny-shaped cells ... old, ~10,000 new cases ... only curative treatment ... #hematology #oncology
Myelodysplastic Syndromes (MDS)

What?
Myelodysplastic syndromes are a group of disorders caused by blood cells that are poorly
unusual bruising or bleeding ... by bleeding (petechiae ... factor (GCSF) treatments ... #diagnosis #hematology ... #oncology
Differentiation Syndrome in APML
Epidemiology:
 • Incidence: common in APL (2-48% depending on the study)
 • Triggers:
Differentiation Syndrome ... common • Imaging: CXR ... - pulmonary opacities ... diagnosis #management #hematology ... #oncology
Aplastic Anemia - Overview

Who?
• M = F
• 3 peaks:	1) Childhood	2) 15-25 years	3) >60 years

What?
• Aplastic anemia
Aplastic Anemia Clinical ... ecchymoses, mucosal bleeding ... and petechiae Causes ... Aplastic #Anemia #oncology ... #hematology #diagnosis
Leukemias Overview: ALL, CML, AML, APML, CLL

Acute leukemias > 20% blasts in the peripheral blood smear
-> AML: Blast crises ... manifestations, hypoxia, CXR ... • Tumor lysis syndrome ... #Leukemia #Hematology ... #Oncology #Diagnosis
Leukostasis vs Tumor Lysis Syndrome
Leukostasis:
 • Pathophysiology: Large, immature blasts and high WBC count cause hyperviscosity
high WBC count cause ... , dyspnea, +/- CXR ... organ damage • Treatment ... Lysis of tumor cells ... diagnosis #management #hematology
Acute Respiratory Distress Syndrome – ARDS: Clinical Cheat Sheet

An acute diffuse, inflammatory lung injury, leading to
Respiratory Distress Syndrome ... – ARDS: Clinical ... to increased pulmonary ... detected on CT or CXR ... the underlying cause
Summary of Oncologic Emergencies

Neutropenic fever:
- Fever + ANC < 500 → start cefepime ± vancomycin (if
): - Hematologic ... Simultaneous clotting and bleeding ... Treat underlying cause ... “big & sticky” cells ... renal failure, pulmonary
Disseminated Intravascular Coagulation (DIC) Overview

Increased Clotting and Consumption of Clotting Factors

Findings:
 • Bleeding
 • Recent history
organ damage Clinical ... Treatment: ... Treat primary cause ... #treatment #management ... #hematology