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Laboratory monitoring in oncology

Medical Affairs and Community Oncology, Alberta Cancer Board, 1220-10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4; cathyduo{at}cancerboard.ab.ca

Jin-Yew Loh, BSc Pharm

Cross Cancer Institute Pharmacy, Alberta Cancer Board, Alberta, Canada

Objectives. To educate pharmacists about the application of laboratory values in oncology.

Methods. Research on drugs used in cancer therapy was conducted using multiple sources, including primary, secondary and tertiary references. Online searches were conducted on Medline (1966-2004), EMBASE (1996-2004) and Ovid databases, using a drug's generic name and key words, such as ‘adverse effects’, ‘hematotoxicity’, ‘renal toxicity’, ‘hepatotoxicity’, ‘cardiotoxicity’, ‘organ dysfunction’, and terms describing chemotherapy-related toxicity, such as ‘tumour lysis syndrome’.

Results. Laboratory monitoring in oncology was separated into the hematologic, hepatic, renal, cardiovascular and pulmonary systems. Laboratory tests applicable to each system are discussed. In addition, tests pertaining to specific drugs used in cancer therapy are explained. This information was compiled into a comprehensive continuing pharmacy education module.

Conclusion. Laboratory monitoring assists the pharmacist in the monitoring of chemotherapy. A general understanding of common tests used in cancer therapy and knowledge specific to drugs used can help the pharmacist tailor drug therapy monitoring.

Key Words: chemotherapy • drug therapy monitoring • laboratory tests • toxicity

References

• American Society of Health-System Pharmacists. ASHP guidelines on preventing medication errors with antineoplastic agents . Am J Health-Syst Pharm 2002; 59: 1648-1668 .[Free Full Text]
• Petros WP, Ericson S. In DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML eds. Hematopoiesis. Pharmacotherapy: a pathophysiologic approach, sixth edition. McGraw-Hill Co. , 2005: 1793-1804.
• Hutson PR. Hematology: red and white blood cell tests. In Lee M ed. Basic skills in interpreting laboratory data. American Society of Hospital Pharmacists , 2004: 441-447.
• Demetri GD, Anderson KG. Bone marrow failure. In Abeloff MD, Armiate JO, Lichter AS, Niederhuber JE eds. Clinical oncology. Churchill Livingstone Inc. , 1995.
• Maxwell MB, Maher KE. Chemotherapy-induced myelosuppression. WB Saunders Co. , 1992.
• Demetri GD. Evidence-based use of hematopoietic growth factors for optimal supportive care of patients with cancer. In Chang AE, Ganz PA, Hayes DF, Kinsella TJ, Pass HI, Schiller JH, Stone RM, Strecher VJ eds. Oncology: an evidence-based approach. Springer Science and Business Media, Inc. , 2006: 1526-1535.
• Balmer CM, Valley AW, Iannuci A. Cancer treatment and chemotherapy. In DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML eds. Pharmacotherapy: a pathophysiologic approach, sixth edition. McGraw-Hill Co. , 2005: 2279-2228.
• Ganong W. Review of medical physiology, fourteenth edition. Appleton & Lange , 1989.
• Cairo M. Dose reductions and delays: limitations of myelosuppressive chemotherapy . Oncology 2000; Suppl 8: 21-29 .
• Hoagland HC. Hematologic complications of cancer chemotherapy . Sem Oncol 1982; 9(1): 95-101 .[Medline] [Order article via Infotrieve]
• Perry MC. Chemotherapy, toxicity, and the clinician . Sem Oncol 1982; 9(1): 1-4 .[Medline] [Order article via Infotrieve]
• Nirenberg A. Hematologic toxicities . Cancer Nurs 2003; 26(suppl 6): 32S-37S .[Medline] [Order article via Infotrieve]
• Kintzel PE. Anticancer drug-induced kidney disorders: incidence, prevention and management . Drug Safety 2001; 24(1): 19-38 .[CrossRef][Medline] [Order article via Infotrieve]
• Brouwer KL, Dukes GE, Powell JR. Influence of liver function on drug disposition. In Evans WE, Schentag JJ, Jusko WJ eds. Applied pharmacokinetics: Principles of Therapeutic Drug Monitoring, third edition. Applied Therapeutics Inc. , 1992: 6-1–6-59.
• Kirchain WR, Gil MA. Drug induced liver disease. In DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML eds. Pharmacotherapy: a pathophysiologic approach, sixth edition. McGraw-Hill Co. , 2005: 713-720.
• King PD, Perry MC. Hepatotoxicity of chemotherapeutic and oncologic agents . Gastroenterol Clin North Am 1995; 24(4): 969-983 .[Medline] [Order article via Infotrieve]
• Garcia G. Hepatic disorders and the influence of liver function on drug disposition. In Melmon KL, Hoffman BB, Nierenberg DW, Carruthers SG eds. Melmon and Morrellis's Clinical Pharmacology: Basic Principles in Therapeutics, fourth edition. McGraw-Hill Co. , 2000.
• Corless Jk, Middleton HM. Normal liver function: A basis for understanding hepatic disease . Archives of Internal Medicine 1983; 143: 2291-2294 .[Abstract/Free Full Text]
• Marshall JL, Hwang J, Malik S, Amin A. Chemotherapy in patients with organ dysfunction. In Chang AE, Ganz PA, Hayes DF, Kinsella TJ, Pass HI, Schiller JH, Stone RM, Strecher VJ. Oncology: an evidence-based approach. Springer Science & Business Media, Inc. , 2006: 1721-1737.
• Lacy CF, Marstron LL, Goldman MP, Lance LL. Drug information handbook, fourteenth edition. Lexi-Comp. , 2006.
• Farkas P, Hyde D. The liver. In Traub SL ed. Basic skills in interpreting laboratory data. American Society of Hospital Pharmacists , 1992: 121-138.
• Farkas J, Farkas P, Hyde D. Liver and gastroenterology tests. In Lee M ed. Basic skills in interpreting laboratory data. American Society of Hospital Pharmacists , 2004: 323-364.
• Kee J. Handbook of laboratory and diagnostic tests, fourth edition. Prentice Hall , 2001.
• Fishbach FT, Dunning III MB. A manual of laboratory and diagnostic tests, seventh edition. Lippincott Williams & Wilkins , 2004.
• Giaccone G, Donadio M, Ferrati P, Ciuffreda L, Bagatella M, Gaddi M, Calciati A. Disorders of serum electrolytes and renal function in patients treated with cis-platinum on an outpatient basis . Div Oncol Med 1984; 31: 433-437 .
• Nolin TD, Himmelfarb J, Matzke. Drug-induced kidney disease. In DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML eds. Pharmacotherapy: a pathophysiologic approach, sixth edition. McGraw-Hill Co. , 2005: 871-890.
• Dowling TC, Comstock TJ. Quantification of renal function. In DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML. eds. Pharmacotherapy: a pathophysiologic approach, sixth edition. McGraw-Hill Co. , 2005: 761-780.
• Matzke GR, Millkin SP. Influence of renal function and dialysis on drug disposition. In Evans WE, Schentag JJ, Jusko WJ eds. Applied pharmacokinetics: Principles of Therapeutic Drug Monitoring, third edition. Applied Therapeutics Inc. , 1992: 8-1–8-49.
• Cockroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine . Nephron 1976; 16: 31-41 .[Medline] [Order article via Infotrieve]
• Marx GM, Galani BE, Steer CB et al. Evaluation of the Cockroft-Gault, Jelliffe and Wright formulae in estimating renal function in elderly cancer patients . Ann Oncol 2004; 15: 291-295 .[Abstract/Free Full Text]
• Briggs JP, Kriz W, Schnermann. Overview of renal function and structure. In Greenberg A, Cehung AK, Coffmann TM, Falk RJ, Jennette JC eds. Primer on kidney diseases. National Kidney Foundation. Academic Press , 1994: 3-20.
• Teshkadi AA. Principles of drug therapy in renal failure. In Greenberg A, Cehung AK, Coffmann TM, Falk RJ, Jennette JC eds. Primer on kidney diseases. National Kidney Foundation. Academic Press , 1994: 298-306.
• Gharib MI, Burnett AK. Cardiac complications. In Chang AE, Ganz PA, Hayes DF, Kinsella TJ, Pass HI, Schiller JH, Stone RM, Strecher VJ eds. Oncology: an evidence-based approach. Springer Science & Business Media, Inc. , 2006: 1411-1423.
• Myers C. The role of iron in doxorubicin-induced cardiomyopathy. WB Saunders Co. , 1998.
• Pai VB, Nahata MC. Cardiotoxicity of chemotherapeutic agents: incidence, treatment and prevention . Drug Safety 2000; 22: 263-302 .[CrossRef][Medline] [Order article via Infotrieve]
• Lipshultz SE, Colan SD, Gelber RD, Perez-Atayde AR, Sallan SE, Sanders SP. Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood . N Engl J Med 1991; 324: 808-815 .[Abstract]
• Kremer LC, van Dalen EC, Offringa M, Ottenkamp J, Voute PA. Anthracyline-induced clinical heart failure in a cohort of 607 children: long term follow up study . J Clin Oncol 2001; 19: 191-196 .[Abstract/Free Full Text]
• Von Hoff D, Rozencweig M, Piccart M. The cardiotoxicity of anticancer agents . Sem Oncol 1982; 9(1): 23-29 .[Medline] [Order article via Infotrieve]
• Schwartz RG, McKenzie WB, Alexander J et al. Congestive heart failure and left ventricular dysfunction complicating doxorubicn therapy. Seven-year experience using serial radionuclide angiocardiograpy . Am J Med 1987; 82: 1109-1118 .[CrossRef][Medline] [Order article via Infotrieve]
• Ginsberg S, Comis R. The pulmonary toxicity of antineoplastic agents . Sem Oncol 1982; 9(1): 34-48 .[Medline] [Order article via Infotrieve]
• Evans SC, Limper AH. Acute toxicities of therapy: pulmonary complications. In Chang AE, Ganz PA, Hayes DF, Kinsella TJ, Pass HI, Schiller JH, Stone RM, Strecher VJ eds. Oncology: an evidence-based approach. Springer Science & Business Media, Inc. , 2006: 1401-1410.
• Sleijfer S. Bleomycin-induced pneumonitis . Chest 2001; 120: 617-624 .[CrossRef][Medline] [Order article via Infotrieve]
• Milavetz G, Smith G. Pulmonary function and related tests. In Traub SL ed. Basic skills in interpreting laboratory data. American Society of Hospital Pharmacists , 1992: 99-108.

Journal of Oncology Pharmacy Practice, Vol. 12, No. 4, 223-236 (2006)
DOI: 10.1177/1078155206072982


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Duong, C. D Articles by Loh, J.-Y. Search for Related Content PubMed PubMed Citation Articles by Duong, C. D Articles by Loh, J.-Y. Pubmed/NCBI databases Medline Plus Health Information Cancer Cancer Chemotherapy Social Bookmarking                         What's this?