Ochsner Louisiana State University Health, Shreveport (Dr Barré); Atrium Health's Carolinas Medical Center, Charlotte, North Carolina (Dr McElwee); Medical University of South Carolina, Charleston (Drs Calhoun, Maldonado, and Bell); and Department of Clinical Pharmacy and Outcome Sciences, University of South Carolina College of Pharmacy, Columbia (Dr Weant).
Adv Emerg Nurs J. 2022;44(2):84-102. doi: 10.1097/TME.0000000000000399.
Patients with hematological malignancies, both treated and untreated, or solid tumors undergoing treatment are at risk of life-threatening complications, which may present in the emergency department (ED). Such emergencies are diverse in etiology and often require prompt treatment. Traditional complications, such as febrile neutropenia, have had recent guideline updates, which incorporate new evidence and a new validated risk stratification tool. In addition, newer approaches to treatment, such as chimeric antigen receptor (CAR) T-cell therapy, are becoming more widely available and have unique associated toxicities. This review discusses the management of the following hematological and oncological emergencies likely to be encountered in the ED: febrile neutropenia, CAR T-cell toxicities, differentiation syndrome, tumor lysis syndrome, hypercalcemia of malignancy, and hyponatremia.
患有血液系统恶性肿瘤（包括已治疗和未治疗的患者）或正在接受治疗的实体瘤的患者存在发生危及生命的并发症的风险，这些并发症可能会在急诊科（ED）出现。这些紧急情况病因多样，往往需要及时治疗。传统并发症，如发热性中性粒细胞减少症，最近有了指南更新，纳入了新的证据和新的经过验证的风险分层工具。此外，嵌合抗原受体（CAR）T 细胞疗法等新的治疗方法越来越普及，具有独特的相关毒性。这篇综述讨论了在 ED 中可能遇到的以下血液系统和肿瘤急症的处理方法：发热性中性粒细胞减少症、CAR T 细胞毒性、分化综合征、肿瘤溶解综合征、恶性高钙血症和低钠血症。
