Adverse events of monoclonal antibodies use in therapy of hematological malignancies

Abstract

Monoclonal antibodies given as monotherapy or combination therapy have emerged as effective treatment options for hematologic malignancies. By prolonging survival, mAbs reduced mortality and improved the clinical prognosis for patients with these diseases. However, despite the effective anticancer activity of mAbs, they induce adverse events. The most common side effects are infusion related reactions (IRR), associated with cytokine release within the first few hours after administration. IRR are usually mild to moderate and manifest in rash, fever, nausea, vomiting, dizziness, headache, hypotension or tachycardia. Other, common toxicities are cytopenias, increasing the risk of infections and bleeding. Most preventive strategies involve the use of glucocorticosteroids, acetaminophen, antihistamines, screening for antibodies against microorganisms and prophylaxis for infections. Cytokine release syndrome, cardiac, pulmonary, neurologic adverse effects occur less frequently. In cases of grade 1–2 toxicity, symptomatic management is recommended, but in more severe symptoms temporary or permanent discontinuation of therapy and use of glucocorticosteroids are recommended. In an effort to limit the incidence and severity of adverse events clinicians should know how to early recognize, precisely assess and timely manage.