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Review of oncological emergencies in small animal patients.

Oncological emergencies can occur at any time during the course of a malignancy and need to be recognized promptly to maximize successful outcomes. Emergencies are characterized as chemotherapy-induced, paraneoplastic syndromes, or directly related to the neoplasm. Prompt identification with treatment of these emergencies can prolong survival and improve quality of life, even in the setting of terminal illness. This review aims to educate the reader on the pathophysiology, clinical presentation and treatment of some of these emergencies, and to review the current veterinary literature to help

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… Coagulopathies are present in the majority of patients; disseminated intravascular coagulation (DIC) occurs in approximately 50% of dogs with HSA (Filppi et al . 1991 ; Maruyama et al . 2004 and Mischke et al . 2005 )., Fine needle aspiration of any masses may be attempted, but can be non‐diagnostic, … Veterinary Surgery 23 , 101 – 106 . 8191668 10.1111/j.1532-950x.1994.tb00453.x Maruyama H. , Miura T. , Sakai M. , Koie H. , Yamaya Y. , Shibuya H. et al. ( 2004 ) The incidence of disseminated intravascular coagulation in dogs with malignant tumor . …

Mechanisms of cytokine release syndrome and neurotoxicity of CAR T-cell therapy and associated prevention and management strategies.

Chimeric antigen receptor (CAR) T-cell therapy has yielded impressive outcomes and transformed treatment algorithms for hematological malignancies. To date, five CAR T-cell products have been approved by the US Food and Drug Administration (FDA). Nevertheless, some significant toxicities pose great challenges to the development of CAR T-cell therapy, most notably cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Understanding the mechanisms underlying these toxicities and establishing prevention and treatment strategies are important. In this r

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… Endothelial activation is likely to contribute to ICANS-associated microthrombi and disseminated intravascular coagulation (DIC). … intravascular coagulation Von Willebrand factor A disintegrin and metalloproteinase with thrombospondin type 1 repeats member 13 Thrombotic thrombocytopenic purpura Glial fibrillary acidic protein Glutamate Apolipoprotein E Cyclophilin A Matrix metalloproteinase 9 Platelet-derived growth factor …

New prognostic biomarkers and therapeutic effect of bevacizumab for patients with non-small-cell lung cancer.

BackgroundSeveral biomarkers have emerged as potential prognostic and predictive markers for non-small-cell lung cancer (NSCLC). Successful inhibition of angiogenesis with the antivascular endothelial growth factor antibody, bevacizumab, has improved the efficacy seen with standard cytotoxic therapy of NSCLC. However, despite such enhanced treatment strategies, the prognosis for patients with advanced NSCLC remains poor.Patients and methodsWe assessed potential biomarkers in 161 NSCLC patients and 42 control patients. Enzyme-linked immunosorbent assay methods were used to evaluate three biomar

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… Disseminated intravascular coagulation in hematologic malignancies. Semin Thromb Hemost. 2010;36:388–403. doi: 10.1055/s-0030-1254048. 40. Nalluri SI. Risk of venous thromboembolism with the angiogenesis inhibitor bevacizumab in cancer patients: a meta-analysis. …

Evaluation of thromboembolic event, basic coagulation parameters, and associated factors in patients with colorectal cancer: a multicenter study.

BackgroundPatients with colorectal cancer are at an increased risk of hemostatic disturbances, and recent studies have shown that coagulation disorders could be the first sign of malignancy. Although coagulopathy is a significant cause of cancer-related death and disability, it is usually underestimated, and there has been no recent scientific evidence regarding the exact burden and its specific determinants. Moreover, the public health importance of the risk of coagulopathy among patients with colorectal polyps has not been addressed.Materials and methodsAn institution-based comparative cross

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… Among CRC patients, clinical and subclinical changes in the coagulation and fibrinolysis systems, thrombotic disease, and disseminated intravascular coagulation are particularly common ( 16 ). …

Dengue-Related Hemophagocytic Lymphohistiocytosis in an Adult: A Case Report and Brief Update.

Dengue virus is an arbovirus transmitted through the bite of infected Aedes mosquitoes. Many unusual clinical features are being reported in dengue. Dengue complicated with hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal condition. Here, we report an 18-year-old otherwise healthy female with dengue fever complicated with HLH. The diagnosis was made by fulfilling the clinical and laboratory criteria of HLH. She was managed successfully with a methylprednisolone pulse regimen. Our case highlights the importance of early recognition of complications and prompt treatment f

EHA Guidelines on Management of Antithrombotic Treatments in Thrombocytopenic Patients With Cancer.

In cancer patients, thrombocytopenia can result from bone marrow infiltration or from anticancer medications and represents an important limitation for the use of antithrombotic treatments, including anticoagulant, antiplatelet, and fibrinolytic agents. These drugs are often required for prevention or treatment of cancer-associated thrombosis or for cardioembolic prevention in atrial fibrillation in an increasingly older cancer population. Data indicate that cancer remains an independent risk factor for thrombosis even in case of thrombocytopenia, since mild-to-moderate thrombocytopenia does n

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… These guidelines exclude TP associated with disseminated intravascular coagulation, 38 congenital bleeding disorders and antiphospholipid syndrome, as well as patients receiving palliative care since the risk-benefit ratio of antithrombotic treatment may be different in those contexts because of the …

Blood Coagulation and Beyond: Position Paper from the Fourth Maastricht Consensus Conference on Thrombosis.

The Fourth Maastricht Consensus Conference on Thrombosis included the following themes. Theme 1: The "coagulome" as a critical driver of cardiovascular disease. Blood coagulation proteins also play divergent roles in biology and pathophysiology, related to specific organs, including brain, heart, bone marrow, and kidney. Four investigators shared their views on these organ-specific topics. Theme 2: Novel mechanisms of thrombosis. Mechanisms linking factor XII to fibrin, including their structural and physical properties, contribute to thrombosis, which is also affected by variation in microbio

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… An exaggerated response may even lead to disseminated intravascular coagulation (DIC) with the formation of microvascular thrombi in various organs. 141 DIC contributes to multiple organ failure and is associated with high mortality in both bacterial and nonbacterial diseases. 134 141 It is not yet clear …

Complete spectrum of adverse events associated with chimeric antigen receptor (CAR)-T cell therapies.

Chimeric antigen receptor (CAR)-T cell therapies have been approved by FDA to treat relapsed or refractory hematological malignancies. However, the adverse effects of CAR-T cell therapies are complex and can be challenging to diagnose and treat. In this review, we summarize the major adverse events, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and CAR T-cell associated HLH (carHLH), and discuss their pathophysiology, symptoms, grading, and diagnosis systems, as well as management. In a future outlook, we also provide an overview of

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… More severe CRS can present as hypotension, hypoxia, capillary leak syndrome, multiple organ failures, disseminated intravascular coagulation (DIC), and even HLS/MAS [ 33 ]. … Generally, ferritin levels exceed 1000 ng/ml at the early phase of sHLH/MAS and will uptrend to more than 10,000 ng/ml with concurrent disseminated intravascular coagulation (DIC) [ 106 ]. …

Skin manifestations associated with systemic diseases - Part II.

The skin, by reflecting internal processes, externalizes what happens inside the body in many diseases. Thus, the skin, as an organ, extrapolates its functions of protection, barrier and signals the existence of systemic diseases, expanding the importance of the dermatologist beyond the skin surface. Thus, the dermatologist investigates diagnostic hypotheses for conditions related to all systems and refers patients to the appropriate specialty. Combined with examination by a trained eye, the skin, due to its easy access, is still the ideal place for performing biopsies, which often clarify the

Carfilzomib-induced thrombotic microangiopathy (TMA) refractory to eculizumab: A case report and literature review.

This case report describes the clinical course of a patient with relapsed IgA kappa multiple myeloma with high-risk cytogenetics. Initially treated with daratumumab-bortezomib-lenalidomide-dexamethasone (Dara-VRD) then transitioned to lenalidomide maintenance. However, he experienced a relapse and was treated with carfilzomib-based therapy (CFZ) but developed drug-induced thrombotic microangiopathy (DI-TMA). Despite receiving eculizumab and supportive care, the patient's condition worsened, leading to encephalopathy and refractory gastrointestinal bleeding in the setting of persistent thromboc

Pericardial effusion secondary to epicardial undifferentiated pleomorphic sarcoma in a young cat.

CASE SUMMARY: A 6.4 kg 3-year-old male neutered indoor-outdoor domestic shorthair cat was referred for further evaluation of non-resolving lethargy and hyporexia of 4 days' duration. Physical examination identified tachypnea with mild respiratory effort and muffled lung sounds bilaterally. Point-of-care ultrasound revealed a large volume of pleural and pericardial effusion (PCE), which was confirmed by thoracic radiography. Echocardiogram indicated normal cardiac function but revealed a mass-like structure along the left epicardium within the pericardial space. After 72 hours in hospital, re-e

Характеризация и последствия серьезных осложнений после аналоговой гематопоиетической трансплантации стволовых клеток: ретроспективное многоцентральное исследование.

ЦЕЛЬ: Описание клинических характеристик и методов лечения, а также выявление факторов, связанных с результатами лечения пациентов, нуждающихся в интенсивной терапии (ИКУ) после аналоговой трансплантации стволовых клеток (ASCT). DESIGN: Многоцентральное ретроспективное когортное исследование. Вечеринка: Eight Университетско-больничное отделение во Франции с января 2013 и июль 2023. ПАТИЕНТЫ: Взрослые (постоянные)≥ 18 (сроки поступления в СИС 90 через несколько дней после выдерживания ASCT. Возражения: нет. ИЗМЕРЕНИЯ И ОСНОВНЫЕ РЕЗУЛЬТАТЫ: 6,342 Получатели ACCT, 355 (В тыс.5.6%) требовался допу

Neuropsychiatric manifestations following chimeric antigen receptor T cell therapy for cancer: a systematic review of clinical outcomes and management strategies.

BACKGROUND: Chimeric antigen receptor (CAR)-T cell therapy has emerged as a transformative modality in the treatment of patients with cancer. However, it is increasingly evident that this therapeutic approach is not without its challenges. The unique nature of CAR-T cells as living drugs introduces a distinct set of side effects. As the application of CAR-T cell therapy expands to treat a broader range of diseases, it becomes increasingly important to devise effective strategies for handling the associated toxicities. Challenges in treating patients with CAR-T cells include addressing complica

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… Nerve compression and neuralgia following CAR-T cell therapy can result from inflammation affecting peripheral nerves or nerve roots, often involving the dorsal root ganglia or spinal nerves. 26 Severe and fatal symptoms, such as acute obtundation, disseminated intravascular coagulation with multifocal … Disseminated intravascular coagulation with multifocal brainstem hemorrhage involves widespread clotting and bleeding within the brainstem. …

Nanomedicine developments in the treatment of metastatic pancreatic cancer: focus on nanoliposomal irinotecan.

Nanoliposomal irinotecan (nal-IRI) was originally developed using an efficient and high-loading capacity system to encapsulate irinotecan within a liposomal carrier, producing a therapeutic agent with improved biodistribution and pharmacokinetic characteristics compared to free drug. Specifically, administration of nal-IRI results in prolonged exposure of SN-38, the active metabolite of irinotecan, within tumors, while at the same time offering the advantage of less systemic toxicity than traditional irinotecan. These favorable properties of nal-IRI, confirmed in a variety of tumor xenograft m

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… DLTs at the next higher dose level (180 mg/m 2 ) included grade 4 neutropenia in one patient and grade 4 febrile neutropenia, grade 4 thrombocytopenia with bleeding, and grade 4 diarrhea in a second patient resulting in death from septicemia and disseminated intravascular coagulation. … In total, five deaths attributed to study treatment were reported, four in the nal-IRI arm (gastrointestinal toxicity, infectious enterocolitis, septic shock, and disseminated intravascular coagulation with pulmonary embolism) and one in the nal-IRI plus 5-FU/LV arm (septic shock). …

Recommendations for the management of the haematological and onco-haematological aspects of Gaucher disease.

Current knowledge of the haematological and onco-haematological complications of type 1 Gaucher disease has been reviewed with the aim of identifying best clinical practice for treatment and disease management. It was concluded that: (i) Awareness of typical patterns of cytopenia can help clinicians distinguish haematological co-morbidities. (ii) Red blood cell studies and complete iron metabolism evaluation at baseline are recommended. (iii) Haemoglobin levels defining anaemia should be raised and used in Gaucher disease treatment and monitoring. (iv) Surgeons should be aware of potential ble

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… The mechanism involved is unclear but may include low-grade disseminated intravascular coagulation or sequestration of coagulation factors by substrate loaded cells. …

Neutrophil diversity and function in health and disease.

Neutrophils, the most abundant type of granulocyte, are widely recognized as one of the pivotal contributors to the acute inflammatory response. Initially, neutrophils were considered the mobile infantry of the innate immune system, tasked with the immediate response to invading pathogens. However, recent studies have demonstrated that neutrophils are versatile cells, capable of regulating various biological processes and impacting both human health and disease. Cytokines and other active mediators regulate the functional activity of neutrophils by activating multiple receptors on these cells,

Research progress on venous thrombosis development in patients with malignant tumors.

The coexistence of venous thromboembolism (VTE) within patients with cancer, known as cancer-associated thrombosis (CAT), stands as a prominent cause of mortality in this population. Over recent years, the incidence of VTE has demonstrated a steady increase across diverse tumor types, influenced by several factors such as patient management, tumor-specific risks, and treatment-related aspects. Furthermore, mutations in specific genes have been identified as potential contributors to increased CAT occurrence in particular cancer subtypes. We conducted an extensive review encompassing pivotal hi

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… Risk factors for CAT The primary clinical presentations of malignancy-associated thromboembolism encompass DVT[ 28 ], pulmonary embolism (PE)[ 29 ], wandering thrombophlebitis, arterial thromboembolism, nonbacterial thrombotic endocarditis, portal vein thrombosis, and disseminated intravascular coagulation …

Preventive strategies for acute kidney injury in cancer patients.

Acute kidney injury (AKI) is a common complication of cancer that occurs in up to 50% of neoplastic patients during the natural history of their disease; furthermore, it has a huge impact on key outcomes such as overall prognosis, length of hospitalization and costs. AKI in cancer patients has different causes, either patient-, tumour- or treatment-related. Patient-related risk factors for AKI are the same as in the general population, whereas tumour-related risk factors are represented by compression, obstruction, direct kidney infiltration from the tumour as well by precipitation, aggregatio

Иммуномодулирующие механизмы мезенхимальных ячеек: цитокинские сети и терапевтический потенциал через иммунные, воспаленные и регенеративные расстройства.

Мезенхимические стромальные клетки (МСЦ) представляют собой многопоточные клетки, характеризующиеся их регенеративной способностью и сильными иммунодуляторными свойствами. В последние годы терапия на базе МСЦ привлекла к себе значительное внимание в качестве потенциального средства лечения широкого круга иммунных и дегенеративных заболеваний. Терапевтические эффекты MSC главным образом получают через паракринную сигнализацию и секрецию цитокинов, которые регулируют иммунную реакцию и содействуют ремонту тканей. В настоящем обзоре основное внимание уделяется пяти ключевым цитокинам, участвующим

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… Administration of 5 × 10 6 cells/kg has been established as a well-tolerated dose, while a tenfold increase results in 20% mortality in rodent models within 24–48 h of infusion, attributed to the development of thromboembolic complications and disseminated intravascular coagulation (DIC)—a life-threatening …

Critically Ill Immunosuppressed Host

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