Cytostatic Disease

Cytostatic disease

Cytostatic disease is a kind of polysyndromic disease that occurs due to the impact of cytostatic factors on the body and is caused by the death of mainly dividing cells, primarily bone marrow, epithelium of the digestive tract, and skin; A common manifestation of cytostatic disease is liver damage.

Etiology: taking cytostatics used in the treatment of tumors or as immunosuppressants, exposure to ionizing radiation (in this case they speak of radiation sickness).

Pathogenesis: death of large numbers of dividing cells with devastation of the bone marrow, disruption of the integrity of the epithelium of the digestive tract, hair loss, as well as damage to varying degrees of all organs and systems. Agranulocytosis, thrombocytopenia, and necrotic ulcerative changes in the gastrointestinal tract that develop in patients can be complicated by secondary processes: sore throat, sepsis, hemorrhages, intestinal perforation, etc. The most important role in the pathological process is played by the dose of the cytostatic and the “power” of the effect, i.e. the amount of drug taken per unit of time (the higher the single dose of the cytostatic, the more severe the damage).

The clinical picture consists of a series of sequentially developing syndromes. Initially, swelling of the oral mucosa appears, which can later be replaced by hyperkeratosis (whitish, difficult-to-remove deposits mainly on the gums); following the oral lesion, sometimes almost simultaneously with it, the number of leukocytes, platelets, and reticulocytes in the blood decreases. Unlike immune agranulocytosis, granulocytes, while decreasing in number, do not disappear completely.

At the height of granulocytopenia, an infection develops (tonsillitis, pneumonia, abscesses at injection sites, etc.); deep thrombocytopenia is accompanied by bleeding from the nose, gastrointestinal tract, and skin hemorrhages. In the bone marrow there is devastation of the cellular composition. Damage to the gastrointestinal tract is manifested by necrotizing enteropathy.

Treatment is similar to that for acute radiation sickness. Prednisolone is not indicated for cytostatic disease. Isolation of patients and compliance with aseptic conditions are mandatory. Antibacterial therapy and platelet transfusions play a decisive role in thrombocytopenic hemorrhagic syndrome. In the absence of severe anemia, blood transfusion is not indicated.

The prognosis is determined by the severity of the lesion. It has been established that without repeated administration of cytostatic drugs, the disease does not recur.