Abstract
In the last decade there has been tremendous effort in offering better therapeutic management strategies to patients with hematologic malignancies. These efforts have ranged from biological to clinical approaches and resulted in the rapid development of new approaches. The main “problem” that comes with the high influx of newly approved drugs, which not only influences hematologists that frequently work with these drugs but also affects other healthcare professionals that work with hematologists in patient management, including intensive care unit (ICU) physicians, is they have to keep up within their specialty and, in addition, with the side-effects that can occur when encountering hematology-specific therapies. Nonetheless, there are few people that have an in-depth understanding of a specialty outside theirs. Thus, this manuscript offers an overview of the most common side-effects caused by therapies used in hematology nowadays, or that are currently being investigated in clinical trials, with the purpose to serve as an aid to other specialties. Nevertheless, because of the high amount of information on this subject, each chapter will offer an overview of the side-effects of a drug class with each reference of the section being intended as further reading.
Highlights
The last decade has brought forward tremendous effort in offering better therapeutic management strategies to patients with hematologic malignancies
The last decade has brought forward tremendous effort in offering better therapeutic J.mCalinn.aMgeedm. 2e0n20t, s9,tr2a90te3gies to patients with hematologic malignancies. These efforts have taken 2eiotfh1e4r translational or clinical approaches and resulted in the rapid development of new approaches that are more tailored to the disease and the patient [1]
The main side-effects of anti-B-cell maturation antigen (BCMA) therapy are represented by reactions to the drug itself, most commonly infusion-related reactions or allergic reactions, in the case of antibodies, and cytokine release syndrome (CRS) in the case of anti-BCMA CAR-T cells [7]
Summary
The last decade has brought forward tremendous effort in offering better therapeutic management strategies to patients with hematologic malignancies These efforts have taken either translational or clinical approaches and resulted in the rapid development of new approaches that are more tailored. The main side-effects of anti-BCMA therapy are represented by reactions to the drug itself, most commonly infusion-related reactions or allergic reactions, in the case of antibodies, and cytokine release syndrome (CRS) in the case of anti-BCMA CAR-T cells [7] Another important target for plasma cells is CD38. The most frequently used compound in this case is idelalisib, which induces severe diarrhea in many patients Because of this toxicity, clinical trials for this drug were generally conducted as monotherapy, as when used in combined therapy they revealed an unacceptable side-effect profile. The first is responsible for inducing pancytopenia to the point that ruxolitinib has to be reduced or discontinued, and the latter transducer could potentially be responsible for the extreme weight gain that these patients observe under treatment [36,37]
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