A predictive model for the detection of tumor lysis syndrome during AML induction therapy

Mato, Anthony R.; Riccio, Brett E.; Li, Qin; Heitjan, Daniel F.; Carroll, Martin; Loren, Alison W.; Porter, David; Perl, Alexander E.; Stadtmauer, Edward A.; Tsai, Donald E.; Gewirtz, Alan M.; Luger, Selina M.

doi:10.1080/10428190500404662

Cited by 79 publications

(55 citation statements)

References 20 publications

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“…In the study by Annemans et al, 20 the incidence of hyperuricemia in 204 patients with AML was 14%, but the incidence of LTLS was not reported. In a recently published series of 194 patients with AML or advanced myelodysplastic syndrome, 8 the incidence of LTLS was 10%, lower than the 17% found in the present study. In any case, the global incidence of LTLS in AML seems to be far lower than the 42-66% reported in ALL and high-grade NHL.…”

Section: 2contrasting

confidence: 83%

“…[5][6][7] However, few studies on TLS are focused on patients with acute myeloid leukemia (AML), and the incidence and outcome of TLS in this population is not well defined. 8,9 With the introduction into clinical practice of new agents, such as recombinant urate oxidase (rasburicase), 10 for the prevention or treatment of TLS, there has been an increased interest in defining the population at high risk of TLS. As TLS is thought to be uncommon in AML, risk factors for TLS have been extrapolated to AML from studies performed in patients with lymphoid malignancies.…”

Section: Introductionmentioning

confidence: 99%

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Tumor lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model

Montesinos¹,

Lorenzo²,

Martı́n³

et al. 2008

Haematologica

191

126

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BackgroundDespite the prophylactic use of allopurinol, tumor lysis syndrome (TLS)-related morbidity and mortality still occur in a number of patients with acute myeloid leukemia (AML). The aim of this study was: (i) to analyze the incidence and outcome of TLS in a large series of patients with AML receiving hyperhydration and allopurinol, (ii) to identify risk factors for TLS, and (iii) to develop a prognostic scoring system for estimating individual risk of TLS.

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Section: 2contrasting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Tumor lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model

Montesinos¹,

Lorenzo²,

Martı́n³

et al. 2008

Haematologica

191

126

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“…16,17 Patients with hematologic malignancies are at higher risk for the development of ATLS than are patients with most solid tumors. 17 Chemotherapy, immunotherapy, corticosteroids, and RT precipitate ATLS.…”

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confidence: 99%

Successful Treatment of Acute Tumor Lysis Syndrome in a Dog with Multicentric Lymphoma

Vickery

Thamm

2007

Veterinary Internal Medicne

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A 6-year-old, female, spayed Scottish Terrier weighing 13 kg was referred to the Colorado State University Animal Cancer Center (CSU-ACC) for radiation therapy (RT) for refractory multicentric lymphoma. The University of Wisconsin (UW)-Madison protocol (cyclophosphamide, a doxorubicin, b vincristine, c asparaginase, d and prednisone e ) 1 was initiated 1 year before presentation at CSU-ACC. A complete remission was achieved after the 1st dose of chemotherapy and continued for the next 11 months. When relapse was detected, a modified UW-Madison protocol substituting actinomycin D f for doxorubicin was initiated. The dog received 1 cycle of this modified protocol before the disease progressed. Asparaginase was administered 1 week before presentation at CSU-ACC. Additional rescue chemotherapy protocols were considered, but the owners opted for RT referral in an attempt to reduce tumor burden.The most predominant features on general physical examination were generalized lymphadenopathy, hepatomegaly, and splenomegaly. The dog was otherwise clinically normal without signs of gastrointestinal upset or lethargy. The dog was not receiving other medications. A CBC revealed mild thrombocytopenia (115,000/ uL; reference range, 200,000-500,000/uL). A serum biochemistry profile obtained 1 week before presentation at CSU-ACC had high alkaline phosphatase (2,000 U/L; reference range, 23-212 U/L) and high alanine transferase (517 U/L; reference range, 10-100 U/L) activities. All other values were within reference range. Hepatomegaly and splenomegaly were evident on left lateral thoracic and abdominal radiographs obtained for RT planning.The plan was to administer two 3-Gray fractions to the entire body on consecutive days. Whole body radiation was planned instead of the more common half-body RT protocol because of the concern that if only half the body was irradiated, the dog's disease would remain in the half of the body that was not irradiated. To help spare as much bone marrow as possible, the dorsal aspect of the cranium, the vertebrae, tail, and the distal radii, ulnae, and tibiae were not included in the radiation field. Acute tumor lysis syndrome (ATLS) after half-body radiation therapy in dogs with lymphoma has been documented. 2,3 In addition, this dog had several risk factors known to promote ATLS development, such as a large tumor burden and abdominal disease. The owners were counseled on the high risk of this dog developing ATLS because of the treatment modality employed as well as known risk factors this dog possessed. The owners opted to continue with the treatment plan. The dog received one 3-Gray fraction of 6-mV photons from a linear accelerator. g Four hours after treatment, emesis and diarrhea developed. The dog was febrile (104.7uF; reference range, 99.0-102.5), tachycardic (140 beats per minute), and tachypneic (70 breaths per minute). Mucous membranes were pale pink and tacky with capillary refill time less than 2 seconds. Femoral pulses were weak. Results of a serum biochemistry profile during this time...

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“…In treatment-associated TLS in AML, the literature is equivocal as to whether preexisting renal insufficiency is a risk factor. 11,12 In addition, "bulky disease" is also cited as a potential risk factor for Spontaneous TLS in AML spontaneous TLS, specifically in lymphoid malignancies and solid tumors. [4][5][6][24][25][26][27][28] In AML, tumor burden and extramedullary bulky disease may be indicated by a high WBC, blast count (periphery or bone marrow), marrow cellularity, monocytic morphology (FAB M4/ M5) and inv 16+ karyotypes.…”

Section: Discussionmentioning

confidence: 99%

“…11,37 The presence of inv 16 is reported to be a risk factor for treatment-associated TLS, however, other potential markers including WBC, blast percentage and FAB subtype are not predictive of treatment-related TLS in AML. 11,12 Data is not available to assess their importance as risk factors for spontaneous TLS in patients with AML. In addition to risk factors, it is important to identify potential causes of TLS in the cases presented in this report.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous tumor lysis syndrome in acute myeloid leukemia: Two cases and a review of the literature

Riccio¹,

Mato²,

Olson³

et al. 2006

Cancer Biology & Therapy

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KEy wORdSspontaneous tumor lysis syndrome, acute spontaneous tumor lysis syndrome, urate nephropathy, tumor lysis syndrome, acute myeloid leukemia, acute renal failure, hyperuricemia ABStRActSpontaneous tumor lysis syndrome (TLS) is a constellation of electrolyte abnormalities and acute renal failure, which occurs in the setting of rapid cell turnover prior to the administration of cytotoxic chemotherapy. While spontaneous TLS is well described in patients with Burkitt's lymphoma, it is thought to occur less commonly in other hematologic malignancies. We present two cases of spontaneous TLS in patients with newly diagnosed acute myeloid leukemia (AML) followed by a review of the literature in this field.

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A predictive model for the detection of tumor lysis syndrome during AML induction therapy

Cited by 79 publications

References 20 publications

Tumor lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model

Tumor lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model

Successful Treatment of Acute Tumor Lysis Syndrome in a Dog with Multicentric Lymphoma

Spontaneous tumor lysis syndrome in acute myeloid leukemia: Two cases and a review of the literature

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