Urolithiasis in Patients Suffering from Malignant Hematologic Diseases

Abstract

PurposeWe performed this study in order to evaluate the incidence and characteristics of urolithiasis in patients with malignant hematologic diseases.Materials and MethodsNine hundred one patients who underwent medical treatment for malignant hematologic disease and 40,543 patients who visited the emergency room and without malignant hematologic diseases were included in our study. The patients with malignant hematologic diseases were divided into two groups depending on their primary treatment. Group I included patients with acute and chronic leukemia (AML, ALL, CML, CLL) for which chemotherapy and steroid therapy was necessary, and group II included patients with anaplastic anemia and myelodysplastic syndrome and who had undergone repeated transfusion for treatment. Comparisons were made between the two groups in respect to the incidence of urolithiasis and the stones' radiopacity.ResultsTwenty nine patients (3.2%) of the 901 malignant hematologic patients were diagnosed with urolithiasis, compared to 575 patients (1.4%) of 40,543 emergency room patients. There was a significant increase of the incidence of urolithiasis in the malignant hematologic group. Compared to the general patients, the patients with malignant hematologic diseases had a higher rate of radiolucent stones (46.6% versus 16.3%, respectively), and the difference was significant.ConclusionThe incidence of urolithiasis for malignant hematologic patients was significantly higher than that for the control group.

A Rare Case of Spontaneous Tumor Lysis Syndrome in Idiopathic Primary Myelofibrosis

“…It is well understood that the cause of increased cell turnover in PMF or any other MPNs is ineffective erythropoiesis that leads to cellular destruction and increased uric acid synthesis. Hyperuricemia in PMF or MPN sometimes causes gout or uric acid renal stones; however, acute renal failure or occlusive uropathy is rare [1,2]. Furthermore, to the best of our knowledge, there is only 1 previous case report like ours.…”

“…Although various causes of acute renal failure in the MPN such as PMF may occur, the tumor lysis syndrome is not well known. However, the use of JAK2 inhibitors has been recently increasing, and TLS have been reported after drug administration [1,2,4,12]. Cairo and Bishop defined laboratory and clinical TLS by modifying the definitions proposed by Hande-Garrow.…”

Obstructive Uropathy as an Initial Presentation of Primary Myelofibrosis: Case Report and Review of Literature

“…Obstructive uropathy in PMF is rare and reported in a patient from EMH enwrapping the renal pelvis, ureter and bladder [7]. Urolithiasis, as a cause of obstructive AKI in MPN has not been reported despite uric acid (UA) stones being commoner in hematological cancers than in general population where the most common renal stones are composed of calcium oxalate [8]. Three factors are commonly implicated in the genesis of UA stones-hyperuricosuria, low urinary volume, and persistently low urinary pH that converts urate to less soluble uric acid [9].…”