Hematological emergencies are defined as acute life-threatening conditions in hematological diseases due to benign blood disorders or hematological malignancies or as a result of its treatment. This article deals of the most common emergencies encountered by hematologists. Emerging clinical situations, predictable or not, are common in the treatment of hematological diseases. However, the rapid development of new targeted drugs in cancer medicine has led to an increase in chronically ill cancer and hematology patients, who are being treated aggressively despite significant comorbidities and higher age. This development will lead to an increase in the number of hematologic emergencies, and these patients will be seen by various specialists. The knowledge of most hematological emergencies is crucial in daily practice. In this review, we discuss the epidemiology, pathophysiology and clinical with an emphasis on the early diagnosis and treatment of these conditions that can significantly affect the patient’s clinical outcome.
KeywordsUrgencyHematological DiseasesClinical Practice
Garratty, G. (2010) Drug-Induced Immune Hemolytic Anemia. Clinical Advances in Hematology and Oncology, 8, 98-101.
Sadler, J.E. (2015) What’s New in the Diagnosis and Pathophysiology of Thrombotic Thrombocytopenic Purpura. Hematology: American Society of Hematology Education Program, 2015, 631-636.
Khatun, H. and Morshed, M. (2015) Thrombotic Thrombocytopenic Purpura: Issues in Diagnosis and Treatment. Mymensingh Medical Journal, 24, 761-764.
Selvi Sabater, P., Espuny Miró, A., Rizo Cerdá, A.M., et al. (2016) Cyclosporin Induced Thrombotic Thrombocytopenic Purpura. Report of Three Cases. Med Clin (Barc), 146, 231-232.
Garcia, G. and Atallah, J.P. (2016) Antineoplastic Agents and Thrombotic Microangiopathy. Journal of Oncology Pharmacy Practice. http://dx.doi.org/10.1177/1078155216628324
Rock, G.A., Shumak, K.H., Buskard, N.A., et al. (1991) Comparison of Plasma Exchange with Plasma Infusion in the Treatment of Thrombotic Thrombocytopenic Purpura. Canadian Apheresis Study Group. The New England Journal of Medicine, 325, 393-397. http://dx.doi.org/10.1056/nejm199108083250604
Omri, H.E., Taha, R.Y., Gamil, A., et al. (2015) Efficacy and Safety of Rituximab for Refractory and Relapsing Thrombotic Thrombocytopenic Purpura: A Cohort of 10 Cases. Clinical Medicine Insights: Blood Disorders, 8, 1-7.
Peyvandi, F., Scully, M., Kremer Hoving, J.A., et al., TITAN Investigators (2016) Caplacizumab for Acquired Thrombotic Thrombocytopenic Purpura. The New England Journal of Medicine, 374, 511-522. http://dx.doi.org/10.1056/NEJMoa1505533
Sayani, F.A. and Abrams, C.S. (2015) How I Treat Refractory Thrombotic Thrombocytopenic Purpura. Blood, 125, 3860-3867. http://dx.doi.org/10.1182/blood-2014-11-551580
Wang, C. (2004) Sickle Cell Anemia and Other Sickling Sindromes. In: Wintrobe’s Clinical Hematology, 11th Edition, Lippincott Williams and Wilkins, Philadelphia, 1262-1311.
Novelli, E.M. and Gladwin, M.T. (2016) Crises in Sickle Cell Disease. Chest, 149, 1082-1093. http://dx.doi.org/10.1016/j.chest.2015.12.016
Taylor, F.B.Jr., Toh, C.H., Hoots, W.K., et al. (2001) Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the International Society on Thrombosis and Haemostasis (ISTH) towards Definition, Clinical and Laboratory Criteria, and a Scoring System for Disseminated Intravascular Coagulation. Thrombosis and Haemostasis, 86, 1327-1330.
Wada, H., Thachil, J., Di Nisio, M., et al. (2013) The Scientific Standardization Committee on DIC of the International Society on Thrombosis Haemostasis. Guidance for Diagnosis and Treatment of DIC from Harmonization of the Recommendations from Three Guidelines. Journal of Thrombosis and Haemostasis. http://dx.doi.org/10.1111/jth.12155
Levi, M., Toh, C.H., Thachil, J., et al. (2009) Guidelines for the Diagnosis and Management of Disseminated Intravascular Coagulation. British Committee for Standards in Haematology. British Journal of Haematology, 145, 24-33. http://dx.doi.org/10.1111/j.1365-2141.2009.07600.x
Sanz, M.A., Grimwade, D., Tallman, M.S., et al. (2009) Management of Acute Promyelocytic Leukemia: Recommendations from an Expert Panel on Behalf of the European Leukemia Net. Blood, 113, 1875-1891. http://dx.doi.org/10.1182/blood-2008-04-150250
De la Serna, J., Montesinos, P., Vellenga, E., et al. (2008) Causes and Prognostic Factors of Remission Induction Failure in Patients with Acute Promyelocytic Leukemia Treated with All-Trans Retinoic Acid and Idarubicin. Blood, 111, 3395-3402. http://dx.doi.org/10.1182/blood-2007-07-100669
Zver, S., Andoljsek, D. and Cernelc, P. (2004) Effective Treatment of Life Threatening Bleeding with Recombinant Activated Factor VII in a Patient with Acute Promyelocyticleukaemia. European Journal of Haematology, 72, 455-456. http://dx.doi.org/10.1111/j.1600-0609.2004.00237.x
Ranieri, V.M., Thompson, B.T., Barie, P.S., et al. (2012) PROWESS-SHOCK Study Group. Drotrecoginalfa (Activated) in Adults with Septic Shock. New England Journal of Medicine, 366, 2055-2064. http://dx.doi.org/10.1056/NEJMoa1202290
Yamakawa, K., Fujimi, S., Mohri, T., et al. (2011) Treatment Effects of Recombinant Human Soluble Thrombomodulin in Patients with Severe Sepsis: A Historical Control Study. Critical Care, 15, R123. http://dx.doi.org/10.1186/cc10228
Brown, J.E., Olujohungbe, A., Chang, J., et al. (2000) All-Trans Retinoic Acid (ATRA) and Tranexamic Acid: A Potentially Fatal Combination in Acute Promyelocyticleukaemia. British Journal of Haematology, 110, 1010-1012. http://dx.doi.org/10.1046/j.1365-2141.2000.02270-8.x
Stewart, A.F. (2005) Clinical Practice. Hypercalcemia Associated with Cancer. New England Journal of Medicine, 352, 373-379. http://dx.doi.org/10.1056/NEJMcp042806
Wysolmerski, J.J. (2012) Parathyroid Hormone-Related Protein: An Update. Journal of Clinical Endocrinology and Metabolism, 97, 2947-2956. http://dx.doi.org/10.1210/jc.2012-2142
Sternlicht, H. and Glezerman, I.G. (2015) Hypercalcemia of Malignancy and New Treatment Options. Therapeutics and Clinical Risk Management, 11, 1779-1788.
Grund, F.M., Armitage, J.O. and Burns, P. (1997) Hydroxyurea in the Prevention of the Effects of Leukostasis in Acute Leukemia. Archives of Internal Medicine, 137, 1246-1267. http://dx.doi.org/10.1001/archinte.1977.03630210112032
Parra-Salinas, I.M., González Rodriguez, V.P. and García-Erce, J.A. (2015) Therapeutic Leukapheresis: 9-Year Experience in a University Hospital. Blood Transfusion, 13, 46-52.
Stone, M.J. and Bogen, S.A. (2012) Evidence-Based Focused Review of Management of Hyperviscosity Syndrome. Blood, 119, 2205-2208. http://dx.doi.org/10.1182/blood-2011-04-347690
Wilson, F.P. and Berns, J.S. (2014) Tumor Lysis Syndrome: New Challenges and Recent Advances. Advances in Chronic Kidney Disease, 21, 18-26. http://dx.doi.org/10.1053/j.ackd.2013.07.001
Mirrakhimov, A.E., Voore, P., Khan, M. and Ali, A.M. (2015) Tumor Lysis Syndrome: A Clinical Review. World Journal of Critical Care Medicine, 4, 130-138. http://dx.doi.org/10.5492/wjccm.v4.i2.130
Straka, C., Ying, J., Kong, F.M., et al. (2016) Review of Evolving Etiologies, Implications and Treatment Strategies for the Superior Vena Cava Syndrome. Springer Plus, 5, 229. http://dx.doi.org/10.1186/s40064-016-1900-7