Pain in Hematologic Malignancies
Hematologic malignancies (HTM) or blood-related cancers (BRC) include leukemia (acute or chronic), lymphomas, and plasma cell disorders. HTM are generally less common than solid tumors, but can be associated with substantial symptom burden, including several pain syndromes, some of which are unique to these conditions. During the course of HTM, pain can be induced by the disease itself, by the diagnostic procedures, or by the different treatment modalities. Pain can also occur from disease-associated complications, secondary to iatrogenic causes, or even at times may be due to unrelated clinical conditions.
In patients with BRC, pain may be the presenting symptom at disease onset, and this kind of pain generally responds with initiation of treatment. Patients under active treatment can report iatrogenic pains of short or long duration. Survivors on the other hand can experience chronic pain due to treatment-related complication or residual post treatment of the disease itself. In patients with advanced, incurable/refractory disease distressing pain symptoms should be managed in context of comprehensive end of life care.
KeywordsBlood-related cancers Hematologic malignancies Bone pain Cancer pain
- 7.Pawloski PA, Larsen M, Thoresen A, Giordana MD. Pegfilgrastim use and bone pain: a cohort study of community-based cancer patients. J Oncol Pharm Pract. 2015 May 7. pii: 1078155215585188. [Epub ahead of print].Google Scholar
- 9.Kirshner JJ, Heckler CE, Janelsins MC, Dakhil SR, Hopkins JO, Coles C, Morrow GR. Prevention of pegfilgrastim-induced bone pain: a phase iii double-blind placebo-controlled randomized clinical trial of the university of rochester cancer center clinical commun oncol program research base. J Clin Oncol. 2012;30(16):1974–9. https://doi.org/10.1200/JCO.2011.37.8364. Epub 2012 Apr 16.CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Moukharskaya J, Abrams DM, Ashikaga T, Khan F, Schwartz J, Wilson K, Verschraegen C, Openshaw T, Valentine J, Eneman J, Unger P, Ades S. Randomized phase II study of loratadine for the prevention of bone pain caused by pegfilgrastim. Support Care Cancer. 2016 Feb 19. [Epub ahead of print].Google Scholar
- 15.Jabbour E, O’Brien S, Kantarjian H, Garcia-Manero G, Ferrajoli A, Ravandi F, Cabanillas M, Thomas DA. Neurologic complications associated with intrathecal liposomal cytarabine given prophylactically in combination with high-dose methotrexate and cytarabine to patients with acute lymphocytic leukemia. Blood. 2007;109(8):3214–8. Epub 2007 Jan 5.CrossRefGoogle Scholar
- 20.Scott BJ, van Vugt VA, Rush T, Brown T, Chen CC, Carter BS, Schwab R, Fanta P, Helsten T, Bazhenova L, Parker B, Pingle S, Saria MG, Brown BD, Piccioni DE, Kesari S. Concurrent intrathecal methotrexate and liposomal cytarabine for leptomeningeal metastasis from solid tumors: a retrospective cohort study. J Neuro Oncol. 2014 Jun 19. [Epub ahead of print].Google Scholar
- 23.Sonneveld P, et al. Dealing with neuropathy in plasma-cell dyscrasias. ASH Education Book. 2010;2010(1):423–30.Google Scholar
- 26.Wade J. Viral infections in patients with hematological malignancies. ASH Education Book. 2006;2006(1):368–74.Google Scholar