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

Sevinir, Betül; Demirkaya, Metin; Baytan, Birol; Güneş, Adalet Meral

doi:10.5152/tjh.2011.06

Cited by 11 publications

(11 citation statements)

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“…The incidence of hyperuricemia in this study was 23% before treatment and 21.3% after treatment. The result shows that the patients have already developed hyperuricemia before treatment which is in agreement with a result reported from a retrospective study in Turkey which showed a hyperuricemia of 26.5% [ 6 ]. But our result is not in agreement with a 40% hyperuricemia, reported from a descriptive study conducted at Liaquat [ 11 ].…”

Section: Discussionsupporting

confidence: 92%

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Evaluation and characterization of tumor lysis syndrome before and after chemotherapy among pediatric oncology patients in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia

et al. 2018

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BackgroundTumor lysis syndrome (TLS) is a life-threatening emergency disorder, caused by an abrupt release of intracellular metabolites after tumor cell death. It is characterized by a series of metabolic manifestations, especially hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. The aim of this study was to evaluate and characterize the incidence of tumor lysis syndrome among pediatric oncology patients before and after treatment.MethodsHospital based prospective cohort study was conducted for 6 months on 61 newly diagnosed pediatric oncology patients. Socio-demographic data was collected by interview administered questionnaire. Patients were followed and the physical diagnosis, imaging and laboratory results were interpreted by senior physicians. Data was entered to and analyzed by SPSS version 23.ResultsAmong 61 pediatric oncology patients 39(63.9%) were males. The mean (±SD) age of the pediatric patients was 6.39 (± 3.67) years ranging from 2 months to 14 years. 29.5% of patients were found to have TLS. There were 11.5% and 18.0% of laboratory TLS (LTLS) and clinical TLS (CTLS) cases respectively. There were72.2% spontaneous and 27.8% treatment induced TLS cases with 23% and 21.3% cases of hyperuricemia and 4.9% and 6.6% cases of hyperkalemia incidence before and after treatment respectively. Only two patients died, in the study period, due to TLS.ConclusionThere was high incidence of TLS irrespective of socio-demographic variation among study participants, suggesting that children with cancer are at risk of developing TLS. As TLS is a life-threatening complication of malignancies, early identification of patients at risk and reducing morbidity and mortality is crucially important.

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Section: Discussionsupporting

confidence: 92%

“…CTLS is defined as LTLS accompanied by one or more clinical manifestations such as cardiac arrhythmia, AKI, seizure, or death with an elevated serum creatinine > 1.5ULN (upper limit of normal) [ 6 ]. TLS is the mainstay for the complication and unfavorable outcome of cancer treatments.…”

Section: Introductionmentioning

confidence: 99%

Evaluation and characterization of tumor lysis syndrome before and after chemotherapy among pediatric oncology patients in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia

et al. 2018

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“…In a multicenter cohort study of 153 high-risk patients with acute leukemia, aggressive NHL, and Burkitt leukemia/lymphoma, the overall incidence of TLS was found to be 30.7% [ 32 ]. Sevinir et al reviewed medical records of 327 children with NHL and ALL retrospectively and reported overall 5.8% incidence of TLS and an incidence of 15.9 % and 0.47% in NHL and ALL, respectively [ 40 ]. In another review of 398 children diagnosed with ALL conducted by Al Bagshi et al, the TLS incidence of 19% has been reported based on Hande and Garrow definitions [ 12 ].…”

Section: Incidence Of Tumor Lysis Syndrome In Hematological Malignmentioning

confidence: 99%

Tumor Lysis Syndrome in Patients with Hematological Malignancies

Belay

Yirdaw

Enawgaw

2017

Journal of Oncology

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Tumor lysis syndrome is a metabolic complication that may follow the initiation of cancer therapy. It commonly occurs in hematological malignant patients particularly non-Hodgkin's lymphoma and acute leukemia due to chemotherapy or spontaneously. It is characterized by a biochemical abnormality such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia and its clinical outcome is directly related to these biochemical abnormalities. Prevention and treatment of tumor lysis syndrome depend on immediate recognition of patients at risk. Therefore, identifying patients at risk and prophylactic measures are important to minimize the clinical consequences of tumor lysis syndrome. Patients with low risk should receive hydration and allopurinol. On the other hand patients with high risk should receive hydration and rasburicase in an inpatient setting. It is important to start therapy immediately, to correct all parameters before cancer treatment, to assess risk level of patients for TLS, and to select treatment options based on the risk level. In this review a comprehensive search of literatures was performed using MEDLINE/PubMed, Hinari, the Cochrane library, and Google Scholar to summarize diagnostic criteria, incidence, predicting factors, prevention, and treatment options for tumor lysis syndrome in patients with hematological malignancies.

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“…In addition, cell lysis occurs during treatment with chemotherapy or cytoreductive agents not only can aggravate elevated serum uric acid (SUA) but also increase urine uric acid (UUA) excretion and acute uric acid nephropathy is possibly anticipated. Therefore, it is generally suggested that allopurinol should be prescribed in these patients to prevent acute uric acid nephropathy (1)(2)(3)(4). Moreover, hyperuricemia has welldescribed reports on the association with physical illnesses such as hypertension, impaired fasting blood glucose and type 2 diabetes, metabolic syndrome, and coronary heart disease in previous studies (5)(6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 98%

Prevalence and risk factors for hyperuricemia and hyperuricosuria in patients with hematologic malignancies

Kunlayawutipong,

Rattanathammethee,

Punnachet

et al. 2024

Front. Med.

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IntroductionHyperuricemia is a common complication of hematologic malignancies, and hyperuricosuria in this population has shown conflicting results. This study aimed to determine the prevalence of hyperuricemia and parameters associated with serum uric acid (SUA) and urine uric acid (UUA) in patients with lymphoma and myeloproliferative neoplasms (MPN).MethodsThis cross-sectional study included adult patients with newly diagnosed lymphoma and MPN at the university-based hospital. Clinical characteristics were collected, and independent risk factors for hyperuricemia and hyperuricosuria were determined using multiple logistic regression.ResultsOne hundred and sixty-five patients were included with a median age of 55 years (45.5–64) and 51.5% were males. There were 91 patients (55.2%) with lymphoma and 74 cases (44.8%) of MPN. Overall, hyperuricemia was prevalent in 43.6% with a median SUA of 6.3 mg/dl (4.6–8) and hyperuricosuria was detected in 39.4% with a median 24-h UUA of 545 mg (365.4–991). Hyperuricemia was observed in patients with lymphoma and MPN in 20.9% and 71.6%, respectively, and hyperuricosuria in 15.4% and 68.9%, respectively. In lymphoma patients, estimated glomerular filtration rate (eGFR) <90 ml/min/1.73 m2 and serum lactate dehydrogenase (LDH) ≥ 250 U/L were associated with hyperuricemia with odds ratio (OR) 3.24, 95% confidence interval (CI) 1.95–11.07, p = 0.006 and OR 2.07, 95%CI 1.62–6.97, p = 0.039), and only elevated serum LDH was related to hyperuricosuria (OR 2.37, 95%CI 1.56–14.29, p = 0.036). In MPN patients, hemoglobin levels <10 g/dl and serum LDH ≥ 640 mg/dl were independent risk factors of hyperuricosuria (OR 1.88, 95%CI 1.42–8.39, p = 0.045 and OR 6.21, 95%CI 1.49–25.74, p = 0.012).ConclusionHyperuricemia in patients with hematologic malignancies was common, notably MPN, and parameters associated with hyperuricosuria were provided. In addition to the utilization of allopurinol in patients at high risk of tumor lysis syndrome, patients without hyperuricosuria may also be of significant interest.

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

Cited by 11 publications

References 23 publications

Evaluation and characterization of tumor lysis syndrome before and after chemotherapy among pediatric oncology patients in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia

Evaluation and characterization of tumor lysis syndrome before and after chemotherapy among pediatric oncology patients in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia

Tumor Lysis Syndrome in Patients with Hematological Malignancies

Prevalence and risk factors for hyperuricemia and hyperuricosuria in patients with hematologic malignancies

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