Rituxan-Induced Tumor Lysis Syndrome in a Patient With Diffuse Large B-Cell Lymphoma

Abstract

Rituximab or Rituxan is a common drug used in the treatment of lymphomas. It is almost always used in conjunction with other chemotherapy regimens. Mechanism of action involves killing of the CD 20+ cells. Rituximab is implicated in precipitating tumor lysis syndrome (TLS) in patients with diffused large B cell lymphoma (DLBCL). The precise pathophysiological mechanism is not well known. Here, we present a case where the patient only received Rituxan for her newly diagnosed B-cell lymphoma which triggered a tumor lysis cascade. This in turn resulted in multiple electrolyte disturbances, multi-organ failure, and mortality. This report discusses the case presentation in addition to the different types of TLS and how this knowledge can be applied in the clinical setting for the future.

Spontaneous Tumor Lysis Syndrome in Prostate Cancer

“…High-turnover hematological malignancies such as Burkitt lymphoma and acute lymphoblastic leukemia are common causes of TLS [5], and regular electrolyte and metabolite monitoring is required during treatment. TLS develops during or shortly after the initiation of therapy using glucocorticoids, hormonal agents, or chemotherapeutics such as rituximab [6]. In contrast to hematological neoplasia, solid tumors seldomly present with TLS, and the spontaneous development of the latter is exceptional [7].…”