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Zorluk: ZorHematology and Oncology

Match each clinical presentation of an adverse drug effect with the most likely responsible antineoplastic or targeted therapy agent.

  • A 42-year-old woman receiving targeted therapy for HER2-positive breast cancer develops an asymptomatic decline in left ventricular ejection fraction that is independent of cumulative dose.Trastuzumab
  • A 38-year-old man receiving a platinum-based regimen for a metastatic non-seminomatous germ cell tumor develops high-frequency sensorineural hearing loss and a rising serum creatinine.Cisplatin
  • A 62-year-old man with chronic myeloid leukemia treated with a tyrosine kinase inhibitor presents with progressive dyspnea; imaging reveals new-onset exudative bilateral pleural effusions.Dasatinib
  • A 68-year-old woman receiving consolidation chemotherapy for acute myeloid leukemia acutely develops nystagmus, dysmetria, and a broad-based gait.Cytarabine
  • A 55-year-old man on adjuvant chemotherapy for stage III colon cancer complains of severe distal dysesthesia and throat tightness that is consistently triggered by drinking cold beverages.Oxaliplatin

Cevap

The correct matches are: Reversible LVEF decline with Trastuzumab; Hearing loss and renal injury with Cisplatin; Pleural effusions with Dasatinib; Acute cerebellar toxicity with Cytarabine; and Cold-induced neuropathy with Oxaliplatin.
Each antineoplastic agent has a well-defined toxicity profile. Trastuzumab causes reversible cardiotoxicity. Cisplatin causes ototoxicity and nephrotoxicity. Dasatinib can cause significant fluid retention, particularly pleural effusions. High-dose cytarabine causes cerebellar toxicity. Oxaliplatin causes acute cold-induced sensory neuropathy.

Adım Adım Çözüm

1
Evaluate the cardiac toxicity profile.
The asymptomatic, non-dose-dependent, and typically reversible LVEF decline points to Trastuzumab.
Differentiating Type I (anthracycline, dose-dependent, irreversible) from Type II (trastuzumab) cardiotoxicity is critical in oncology management.
2
Evaluate the ototoxicity and nephrotoxicity profile.
The combination of sensorineural hearing loss and rising creatinine points to Cisplatin.
Platinum-based alkylating-like agents have distinct toxicities; cisplatin is the most ototoxic and nephrotoxic of the group.
3
Evaluate the respiratory toxicity in CML.
Exudative pleural effusions in a patient on a tyrosine kinase inhibitor strongly point to Dasatinib.
While imatinib commonly causes periorbital edema, dasatinib specifically causes pleural effusions and pulmonary hypertension.
4
Evaluate the acute neurotoxicity in AML treatment.
Acute onset of nystagmus and ataxia during consolidation therapy identifies Cytarabine cerebellar toxicity.
High-dose regimens of cytarabine require routine neurological checks before each dose due to this specific risk.
5
Evaluate the peripheral neuropathy triggered by cold.
Cold-exacerbated dysesthesia and throat tightness identify Oxaliplatin.
Unlike the chronic stocking-glove neuropathy of vinca alkaloids or taxanes, oxaliplatin causes this unique acute cold-induced phenomenon.

Anahtar Kavram

Adverse effect profiles of antineoplastic agents
Tahmini Süre:1m 30s
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Konular

Hematology and Oncology

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