Tumor Lysis Syndrome in Children With Non-Hodgkin Lymphoma

Objective: To observe the out come of tumor lysis syndrome (TLS) following treatment with hydration and alkalinization in children with acute lymphoblastic leukemia.Methodology: This is an observational study which included 30 diagnosed ALL children who were at high risk of developing TLS in the Department of Pediatric Hematology & Oncology, BSMMU, from January 2010 to July 2010. Result: The mean (±SD) age was found 10.2±2.9 years and maximum (46.7%) numbers were found between 11 to 15 years. Male female ratio was 2.3:1. High risk patients for developing TLS presented with huge organomegaly such as hepatomegaly, splenomegaly, and lymphadenopathy associated with fever, anemia, and bony tenderness. For diagnosis of Acute Lymphoblastic Leukemia (ALL) bone marrow study was done in all patients and immunophenotyping in 40.0% patients. Hydration, Alkalinization, Tab Allopurinol and Oral Aluminum hydroxide were used in all study patients while treatment. WBC and serum uric acid were found higher in all patients during baseline investigation. After hydration and Alkalinization serum potassium, serum phosphate, serum calcium and serum creatinine level were normal within 72 hours and serum uric acid within day five. Mortality was found 6.7% and the cause of mortality was septicemia. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12598 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct12

show abstract

“…Dialysis was not required while treatment (Table IV). The study was almost similar to the treatment used by Alavi et al (2006) 7 , Ozdemir et al…”

Section: Methodssupporting

confidence: 68%

Outcome of Tumor Lysis Syndrome with Hydration and Alkalinization in Children with Acute Lymphoblastic Leukemia

Sultana

Islam

Akhtar

et al. 2012

Bangladesh J Med Sci

View full text Add to dashboard Cite

show abstract

“…This is similar to other reports from the same geographical location. For instance, TLS was reported in 22.5% of 59 patients with NHL, approximately 50% in the form of LTLS [18].…”

Section: Discussionmentioning

confidence: 99%

Hyperuricemia and tumor lysis syndrome in children with non-Hodgkin’s lymphoma and acute lymphoblastic leukemia

Sevinir¹,

Demirkaya²,

Baytan³

et al. 2011

Turk J Hematol

View full text Add to dashboard Cite

Objective: This study aimed to examine the incidence, clinical characteristics, and outcome of hyperuricemia and tumor lysis syndrome (TLS) in children with non-Hodgkin's lymphoma (NHL) and acute lymphoblastic leukemia (ALL). Materials and Methods: This retrospective study included data from 327 patients (113 NHL and 214 ALL). Results: Hyperuricemia occurred in 26.5% and 12.6% of the patients with NHL and ALL, respectively. The corresponding figures for TLS were 15.9% and 0.47% (p=0.001). All hyperuricemic NHL patients had advanced disease and renal involvement was present in 53%. All hyperuricemic ALL patients had a leukocyte count >50,000 mm 3 at the time of diagnosis. Among the hyperuricemic NHL and ALL patients, 96.6% and 66.6% had LDH ≥500 UI/L, respectively. Treatment consisted of hydration and allopurinol; none of the patients received urate oxidase. Among the patients that developed TLS, 26.3% had laboratory TLS, 42.1% had grade I or II TLS, and 31.6% had grade III or IV TLS. Uric acid levels returned to normal after a mean period of 3.5±2.5 and 3.05±0.8 d in NHL and ALL groups, respectively. In all, 7% of the patients with hyperuricemia required hemodialysis. None of the patients died. Conclusion: In this series the factors associated with a high-risk for TLS were renal involvement in NHL and high leucocyte count in ALL. Management with allopurinol and hydration was effective in this group of patients with high tumor burden. (Turk J Hematol 2011; 28: 52-9) Key words: Non-Hodgkin's lymphoma, leukemia, tumor lysis syndrome, hyperuricemia, children Received: January 28, 2010 Accepted: April 30, 2010 Özet Amaç: Çalışmanın amacı NHL ve ALL'li çocuklarda hiperürisemi ve TLS sıklığını, klinik özellikleri ve sonuçlarını tanımlamaktır.

show abstract

“…These malignancies share the characteristics of a high proliferative rate, large tumor burden, or high sensitivity to cytotoxic therapy. [1][2][3][4][5] In some cases, tumor lysis syndrome can lead to acute renal failure and even death. The key to the management of tumor lysis syndrome includes awareness of its causes, identification of high-risk patients, implementation of appropriate prophylactic measures, vigilant monitoring of electrolyte levels in patients undergoing chemotherapy, and initiation of more active treatment measures when necessary.…”

mentioning

confidence: 99%