Skip to main content
SpringerLink
Log in

Table 1A

From: Complications and Toxicities Associated with Cancer Therapies in the Intensive Care Unit

 

Neuro

Cardiac

Pulmonary

Renal

GI

Endocrine

Miscellaneous

Notes

 

Encephalopathy

Seizures

Heart failure

Thromboembolism

Arrhythmias

QT prolongation

Pericardial effusions

Severe hypertension

Pneumonitis

Pulmonary edema

Pulmonary hypertension

Pleural effusions

Organizing pneumonia

Diffuse alveolar hemorrhage

SIADH – hyponatremia

Renal failure

Hemorrhagic cystitis

Bowel perforation

Neutropenic colitis

Pancreatitis

Hepatotoxicity

Adrenal insufficiency

Hypophysitis

Hyperglycemia

Thyroid disorders

Cytokine release syndrome

Differentiation syndrome

Opportunistic infections

Bleeding (severe)

Rhabdomyolysis

Stevens-Johnson syndrome or Toxic epidermal necrolysis

 

5-Fluorouracil (5-FU)

X

X

X

 

X

    

X

                    

X

See Note 1

Abemaciclib

   

X

                

X

          

See Note 2

Acalabrutinib

    

X

X

                     

X

X

  

See Note 3

Ado-trastuzumab

X

 

X

     

X

           

X

       

X

  

See Note 4

Afatinib

  

X

     

X

      

X

    

X

         

X

See Note 5

Aflibercept

X

  

X

   

X

       

X

 

X

          

X

  

See Note 6

Aldesleukin

X

   

X

    

X

     

X

    

X

   

X

      

See Note 7

Alectinib

    

X

   

X

      

X

    

X

  

X

       

See Note 8

Alemtuzumab

                           

X

   

See Note 9

  1. 1Cases of hyperammonemic encephalopathy have occurred within 72 h of infusion initiation. Most cases of hyperammonemic encephalopathy are treated with ammonia lowering therapies. Cases of acute cerebellar syndrome have also been reported. Higher incidence of cardiac toxicity with infusion vs bolus dosing of 5FU [60, 149, 151, 238]
  2. 2Delayed hepatotoxicity (ALT and AST elevations of grade 3 or greater) with median onset 2–6 months, generally resolving to less than grade 3 in 2 weeks with dose interruption, reduction, discontinuation, or delay [137, 225]
  3. 3Atrial fibrillation and flutter can occur. PJP prophylaxis and CMV monitoring are recommended. Major hemorrhage has been reported with BTK inhibitors. Consider withholding 3–7 days prior to procedures depending on risk of bleeding [13, 41]
  4. 4GI, CNS, and pulmonary bleeding have occurred in trials with some fatalities. Higher risk in patients on anticoagulants or antiplatelet therapy. Liver failure, hepatic encephalopathy, idiopathic noncirrhotic portal hypertension, and death have been reported [82]
  5. 5Hepatic impairment is rare but fatalities have been reported. Diarrhea can be severe and may lead to dehydration and subsequent renal failure [31]
  6. 6Hypertension onset is generally within the first two cycles. Proteinuria, nephrotic syndrome, and TMA have been associated with ziv-aflibercept [210]
  7. 7High-dose IL-2 has a black box warning for capillary leak syndrome, CNS toxicity, and increased risk for disseminated infection. Use should be restricted to patients with normal cardiac and pulmonary function. IL-2 should only be administered under the supervision of an experienced cancer chemotherapy physician in a facility with ICU facilities available. Consensus guidelines are available to provide criteria for safe administration and toxicity management [66, 196]
  8. 8Symptomatic bradycardia can occur. When treating hypertension use caution when administering antihypertensive agents that can cause bradycardia. Severe renal events are rare but fatal cases have been reported. The majority of hepatotoxicity occurs within the first 3 months of therapy. Monitor CPK and for signs or symptoms of muscle pain or weakness. Median time to grade 3 CPK elevations 14 days [86]
  9. 9PJP and HSV prophylaxis is recommended from initiation of treatment until 2 months following last dose or until CD4+ >200/mm3 [91]
Back to chapter page

Search

Navigation