Acute tumor lysis syndrome in Hodgkin disease

Mahajan, Amita; Nirmal, Stephen; English, Martin; Jenney, Meriel; Lazda, E.D.

doi:10.1002/mpo.10045

Cited by 8 publications

(3 citation statements)

References 6 publications

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“…The most frequently reported cause of death in human ATLS patients is acute oliguric renal failure due to an acute urate nephropathy (2,4). In these patients, mechanisms for uric acid excretion and processing nucleic acid by-products are overwhelmed (5). Normally, free nucleotides are broken down into purine and pyrimidine bases.…”

Section: Discussionmentioning

confidence: 99%

“…Although spontaneous onset of ATLS does occur, the syndrome is most often associated with aggressive chemotherapy of lymphoproliferative malignancies. Factors that predispose patients to an increased risk for ATLS include not only the type of cancer (2,5), but also increased tumor mass bulk (1, 4) sensitivity to drug therapy (4), serum LDH above 600 iu (associated with areas of tumor ischemia, and used to predict tumor bulk) (2, 4, 6), renal status (1, 4), serum uric acid levels (1,4), and abdominal location of the neoplasm (1, 2, 6). There is increased risk of ATLS with any preexisting neoplastic condition that can result in either increased cell death and/or a reduced capacity to metabolize and eliminate cell breakdown products.…”

Section: Discussionmentioning

confidence: 99%

“…processing nucleic acid by-products are overwhelmed (5). Normally, free nucleotides are broken down into purine and pyrimidine bases.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Acute Tumor Lysis Syndrome in a DBA/1J Mouse: A Case Report and Review

et al. 2003

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Spontaneous acute tumor lysis syndrome (ATLS) was diagnosed in a 10-month-old female DBA/1J sentinel mouse with leukemic lymphoma. The mouse was unable to maintain balance and died shortly after being observed rolling around in its cage. Disseminated neoplastic disease, including a large cranial mediastinal mass, enlarged lymph nodes and splenomegaly, was present at necropsy. Histopathologic examination revealed widespread massive necrosis of lymphoblastic tumor cells, and widely disseminated microemboli composed of nuclear and cytoplasmic cell debris. Although ATLS is widely recognized as an oncologic emergency in humans, acute lesions of ATLS have not been described. The mechanical obstruction of capillary beds by microemboli originating from disintegrating necrotic tumor cells was the likely cause of clinical signs and death in this mouse. We propose that similar microemboli may contribute to the pathogenesis of the acute renal failure and other clinical signs associated with ATLS in humans. Recognition of spontaneous ATLS in laboratory animals is especially important in studies that assess the efficacy and/or toxicity of anticancer treatments, where early deaths due to ATLS might mistakenly be attributed to a direct test article effect.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%