Symptom Management

Patients undergoing hematopoietic stem-cell transplantation (HSCT) often receive highly emetogenic, multiday conditioning chemotherapy. Many patients experience nausea and vomiting, which may negatively affect quality of life, despite receiving triple therapy with dexamethasone, a neurokinin-1 (NK-1) receptor antagonist, and serotonin receptor antagonists (5-HT₃).

Clostridium difficile Infection Management in Adults Undergoing Stem-Cell Transplant

Tetyana Melnyk, PharmD

Clostridium difficile–related diarrhea is one of the most common types of nosocomial diarrhea in the United States, with an incidence of 15% to 25%.¹ Infectious diarrhea resulting from C difficile is a common complication in patients undergoing hematopoietic stem-cell transplant (HSCT), with higher rates in those undergoing allogeneic than autologous HSCT (12%-18% vs 6%-8.5%, respectively).^2-4

Preventing Chemotherapy-Induced Infertility in Female Patients

Dr. Shiela McCollam, PharmD, BCPS, Dr. Colleen Shipman, PharmD, MPH, BCPS, Dr. Joseph Bubalo, PharmD, BCPS, BCOP, Dr. Sacha Krieg, MD, PHD, FACOG

Many chemotherapy agents have the potential to impair fertility.^1,2 Infertility resulting from cancer treatments can affect the quality of life for young cancer survivors.³ In 2017, an estimated 852,630 female patients were diagnosed with cancer in the United States, of whom 10.5% were aged <45 years.⁴

Zain Al-Jammali, PharmD, Brent Beckner, PharmD, Dr. Joseph Bubalo, PharmD, BCPS, BCOP

A paradigm shift in the management of relapsed or refractory B-cell chronic lymphocytic leukemia (CLL) and low-grade non-Hodgkin lymphoma (NHL) has evolved in recent years. With increased use of targeted therapies, ibrutinib, an oral Bruton’s tyrosine kinase (BTK) inhibitor, is an integral therapeutic option for patients with treatment-naïve and treatment-experienced CLL or low-grade NHL. Ibrutinib therapy demonstrated superior overall response rates compared with ofatumumab and other agents in treatment-experienced patients with CLL.

Anthracycline-Induced Cardiotoxicity in Adults

Linda Blake, PharmD, PhD, BCPS, Alison Palumbo, PharmD, MPH, BCOP, Amber Diaz, PharmD, BCOP, Dr. Joseph Bubalo, PharmD, BCPS, BCOP

Anthracyclines, such as doxorubicin or epirubicin, have been used for decades for the treatment of a variety of cancers, including breast cancer, sarcoma, lymphoma, and leukemia.

Management of Rasburicase-Induced Hemolytic Anemia

David A. Kaland, PharmD, BCOP, Michelle A. Borg, PharmD

This symptom management article describes the approach to rasburicase-induced hemolytic anemia in patients with glucose-6-phosphate dehydrogenase deficiency, which may occur intravascularly in this patient population.

Prevention of Thromboembolism in Patients with Multiple Myeloma

Nicole Gerardo, PharmD

For patients diagnosed with cancer, the annual incidence of VTE is approximately 20%, and the risk for VTE in this patient population is estimated to be 7 times higher than in the general population.

Hypertension Caused by VEGF-Signaling Pathway Inhibitors

Donald C. Moore, PharmD, BCPS, BCOP, Margaret M. Kientzel, PharmD, Adenike Fasan, BPharm

Targeting and inhibiting the vascular endothelial growth factor (VEGF)-signaling pathway has become an integral modality in the treatment of a variety of malignancies, including renal-cell carcinoma (RCC); glioblastoma; hepatocellular carcinoma; gastrointestinal stromal tumors; and colorectal, lung, gastric, and ovarian cancers.

A Taxing Consequence: Taxane Acute Pain Syndrome

Mark L. Zangardi, PharmD, BCOP

This section provides a quick update of symptomatic conditions in oncology and their management. Readers are invited to submit brief updates following the guidelines at www.JHOPonline.com.

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