Peds Heme/Onc Flashcards
Tumor lysis syndrome is associated with what levels in blood?
K, phos, low calcium (from binding to phos), uric acid, nucleic acids, LDH, AKI
Tumor lysis syndrome prophylaxis
Hydration + allopurinol
Elevated uric acid: rasburicase
What is CNS management of ALL in high-risk?
High-risk: IT methotrexate or triple IT (MTX, cytarabine, hydrocortisone) + high-dose MTX with leucovorin rescue, L-asparaginase, and/or cranial RT (limited to highest risk of CNS relapse)
What is CNS management of ALL in low-risk?
Low-risk: IT methotrexate or triple IT prophylaxis
What are toxicities of IT therapy for ALL CNS management?
Seizures, leukoencephalopathy, neurocognitive deficits
What is in all ALL remission induction therapy?
- Glucocorticoid
- Vincristine
- Asparaginase
Sometimes: Anthracycline
What is conducted at end of remission therapy to gauge measurable residual disease (MRD)?
Bone marrow biopsy
What are the criteria for ALL complete remission?
Blasts: <5%
No circulating blasts/extramedullary disease
Inotuzumab
CD22 antibody-drug conjugate (ADC)
Side effects: hepatotoxicity, fatal sinusoidal obstruction syndrome, veno-occlusive disease
Blinatumomab
CD3-CD19 BiTE
Consolidation for HR de novo or r/r ALL/LBL
Side effects: CRS, neurotoxicity
Tisagenlecleucel
CD19 CAR-T
Aminocaproic acid
Antifibrinolytic agent - binds to plasminogen and prevents binding to fibrin, preventing conversion to plasmin and preventing fibrin degradation
Tranexamic acid
Antifibrinolytic - blocks lysine binding sites on plasminogen molecules, inhibiting interaction and formation of plasmin
Emicizumab/Hemlibra
Prophylaxis for Hemophilia A
Bispecific antibody that mimics function of factor 8 and brings together factor 9 and 10
Eloctate
Recombinant Factor 8, Fc fusion protein
