Supportive Care

Question 1

Laboratory feature of tumor lysis syndrome

Answer 1

Abnormality in two or more of within 3 days before or up to 7 following:
days after chemotherapy:
• Uric acid > 8 mg/dL or 25% increase
• Potassium > 6 mEq/L or 25% increase
• Phosphate > 4.5 mg/dL or 25% increase
• Calcium < 7 mg/dL or 25% decrease

Question 2

Cause of tumor lysis: disease, hematologist and solid

Answer 2

Hematological diseases
• Acute leukemia
• Chronic leukemia
• Non-Hodgkin’s lymphoma
specially Burkitt’s lymphoma,
DLBCL
• Multiple myeloma
Solid tumors (uncommon)
• Breast cancer
• Seminoma
• Sarcomas
• Medulloblastoma
• HCC
• NSCLC-SCLC(more)
• Metastatic colon cancer

Question 3

Drug causing tumor lysis syndrome

Answer 3

Cisplatin
• Paclitaxel
• Methotrexate
• Cytarabine
• Cladribine
• Fludarabine
• Mitoxantrone
• Etoposide
• Capecetabine
• Rituximab
• Bortezomib

Question 4

Onset of different feature of TLS

Answer 4

6 hours – 3 days: hyperkalemia
1 – 2 days Hyperphosphatemia, Hypocalcemia
2 – 3 days Hyperuricemia
3 – 4 days Acute renal failure

Question 5

Drug causing hand foot syndrome

Answer 5

High dose 5FU, liposomal doxorubicin, cytarabine
Capecitabine
Cabozantinib, regorafenib, sorafenib, sunitinib, axitinib, lapatinib

Question 6

Drug causing radiation recall

Answer 6

Doxorubicin, daunorubicin, paclitaxel, docetaxel, etoposide, bleomycin, dactinomycin, MTX, 5FU, capecitabine, gemcitabine, cytarabine, cyclophos, hydroxyurea, lomustine, melphalan, tamoxifen, and vinblastine.

Question 7

Vesicant drug

Answer 7

Alkylating agents : Mechlorethamine
Anthracyclines : Doxorubicin, daunorubicin, epirubicin, idarubicin Non-anthracycline : Dactinomycin, mitoxantrone, mitomycin C Vinca-alkaloids : Vinblastine, vincristine, vinorelbine, vindesine
Others : Trabectedin, amsacrine [Skeel – taxens are low vesicant]

Question 8

Irritant drug

Answer 8

Alkylating agents : Cisplatin, carboplatin, oxaliplatin, ifosfamide, cyclophosphamide, bendamustine, melphalan, thiotepa, busulfan, carmustine
Antimetabolites : Methotrexate, cladribine, fludarabine, 5-FU, gemcitabine, cytarabine
Others: Bleomycin, etoposide, irinotecan, bortezomib, paclitaxel, docetaxel, trastuzumab

Question 9

Treatment of extravasating: warm compresses needed in

Answer 9

Vinca alkaloids, etoposide, teniposide, oxaliplatin

Question 10

Treatment of extravasating. Cold compresses required in.?

Answer 10

Anthracyclines: doxorubicin, dono, epirubicin, idarubicin,
Alkylating agent: cpl, carboplatin, paclitaxel, docetaxel, irinotecan, dactinomycin, mitomycin