Acute Tumor Lysis Syndrome after Cisplatin and Gemcitabine for Treatment of Urothelial Carcinoma of the Renal Pelvis: Case Report and Review of Literature

Wang, Jue; Ruvinov, Kirill; Cassaday, Jill; Trepeta, Richard

doi:10.21767/2386-5180.1000165

“…There is currently no standard of treatment for small cell carcinoma and treatment options have only been extrapolated from small cell carcinoma of the lung. The majority of tumor lysis syndrome cases reported so far in the literature occurred after first-line therapy [5][6][7][8][9][10][11][12][13]. For the first time, we reported a case of TLS occurred after…”

Section: Discussionmentioning

confidence: 99%

“…Prior to 2017, only one case of TLS in urothelial carcinoma had been reported in literature [3,4]. Subsequently, our team reported two cases of TLS in urothelial carcinoma [5,6]. The incidence of TLS in urothelial cancers is currently unknown and we believe these clinical observations deserve further investigation.…”

Section: Introductionmentioning

confidence: 86%

“…Cellular death mediated by cancer therapy or spontaneous cellular lysis in rapidly dividing tumors leads to the release of intracellular contents comprised of potassium, phosphorous and uric acid. Although the vast majority of TLS cases are associated with rapidly proliferating hematologic malignancies [2], there are increasing reports of TLS in solid tumor with the availability of more effective treatment during last two decades [3][4][5][6][7][8][9][10][11][12][13]. Prior to 2017, only one case of TLS in urothelial carcinoma had been reported in literature [3,4].…”

Section: Introductionmentioning

confidence: 99%

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2019

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Background: Tumor lysis syndrome (TLS) is an oncologic emergency with limited treatment options. Although the vast majority of TLS is associated with rapidly proliferating hematologic malignancies, it is often overlooked in solid tumor cases and has only been rarely associated with urothelial carcinomas. The objective of this review is to investigate the clinical characteristics and outcomes of TLS in patients with urothelial carcinoma.Methods: Retrospective literature and case review and pooled analysis.Results: Four cases of TLS in urothelial carcinoma were identified in over 180 published cases of TLS in solid tumors; one additional case was included from our patient database. The median age of these patients was 72 years (range: 63-77) and 60% were female. Two patients had urothelial carcinoma of the renal pelvis and three had bladder cancer with metastases. All of these cases were associated with therapy-induced TLS with a median time to event of 14 days (range: 8-22 days) after receiving chemotherapy. Laboratory parameters were consistent among all cases with elevations in uric acid and LDH, hypocalcemia, hyperphosphatemia, and hyperkalemia. Treatment for TLS included aggressive supportive measures with intravenous hydration. One patient received hemodialysis; four of the five patients received urate oxidase, while one patient received allopurinol as treatment support. The mortality in this case series was 60%. Conclusion:TLS in urothelial cancer is associated with very high mortality. TLS should be considered as a differential diagnosis when evaluating acute kidney injury and electrolyte abnormalities in patients with urothelial cancer especially in cases of high tumor volume and rapid growth.

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Evolving insight of adverse drug reaction associated with breast cancer drugs

Ghai¹,

Sheela²,

Kumar³

et al. 2021

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Tumor Lysis Syndrome Associated with Urothelial Cancer: A Case Series

Wang

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2019

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Background: Tumor lysis syndrome (TLS) is an oncologic emergency with limited treatment options. Although the vast majority of TLS is associated with rapidly proliferating hematologic malignancies, it is often overlooked in solid tumor cases and has only been rarely associated with urothelial carcinomas. The objective of this review is to investigate the clinical characteristics and outcomes of TLS in patients with urothelial carcinoma.Methods: Retrospective literature and case review and pooled analysis.Results: Four cases of TLS in urothelial carcinoma were identified in over 180 published cases of TLS in solid tumors; one additional case was included from our patient database. The median age of these patients was 72 years (range: 63-77) and 60% were female. Two patients had urothelial carcinoma of the renal pelvis and three had bladder cancer with metastases. All of these cases were associated with therapy-induced TLS with a median time to event of 14 days (range: 8-22 days) after receiving chemotherapy. Laboratory parameters were consistent among all cases with elevations in uric acid and LDH, hypocalcemia, hyperphosphatemia, and hyperkalemia. Treatment for TLS included aggressive supportive measures with intravenous hydration. One patient received hemodialysis; four of the five patients received urate oxidase, while one patient received allopurinol as treatment support. The mortality in this case series was 60%. Conclusion:TLS in urothelial cancer is associated with very high mortality. TLS should be considered as a differential diagnosis when evaluating acute kidney injury and electrolyte abnormalities in patients with urothelial cancer especially in cases of high tumor volume and rapid growth.

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Acute Tumor Lysis Syndrome after Cisplatin and Gemcitabine for Treatment of Urothelial Carcinoma of the Renal Pelvis: Case Report and Review of Literature

Cited by 3 publications

References 7 publications

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Evolving insight of adverse drug reaction associated with breast cancer drugs

Tumor Lysis Syndrome Associated with Urothelial Cancer: A Case Series

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