Spontaneous tumour lysis syndrome associated with contrast dye iohexol use in mantle cell lymphoma

Yun, Seongseok; Vincelette, Nicole D.; Phan, Tuan; Anwer, Faiz

doi:10.1136/bcr-2014-204113

Cited by 6 publications

(4 citation statements)

References 30 publications

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“… 22 – 24 Less frequent, spontaneous TLS can develop prior to initiation of anticancer therapy. 11 , 13 , 25 , 26 Even invasive procedure like biopsies, 16 embolization, 27 , 28 and tumor surgery 29 could lead to TLS.…”

Section: Incidencementioning

confidence: 99%

Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase

Alakel¹,

Middeke²,

Schetelig³

et al. 2017

OTT

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Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs in oncologic and hematologic patients with large tumor burden, either due to cytotoxic therapy or, less commonly, spontaneously because of massive tumor cell lysis. TLS is clinically characterized by acute renal failure, hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. While limited options are available for treating TLS, identifying patients at high risk for developing TLS and prevention in high-risk patients remain an important aspect in the treatment of cancer patients. In general, treatment of TLS consists of intensive hydration, stimulation of diuresis, and, more specifically, in the use of allopurinol and rasburicase. Rasburicase, a recombinant urate oxidase, rapidly and effectively reduces hyperuricemia, which subsequently significantly decreases the risk of acute renal failure and other clinical manifestations of TLS. For this review, a comprehensive literature search using the term “tumor lysis syndrome” and/or “rasburicase” was performed considering articles listed in MEDLINE. Incidence, prevention, and therapy of TLS with a special focus on the role of rasburicase are discussed. We evaluated 120 relevant articles including 35 case reports, 32 clinical trials, and 14 meta-analyses.

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Section: Incidencementioning

confidence: 99%

Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase

Alakel¹,

Middeke²,

Schetelig³

et al. 2017

OTT

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“…The patient in this case did not have the blastoid variant. The patient had intrinsic risk factors that predisposed him to developing STLS, including a WBC count of 695.8 × 10 9 /L, massive splenomegaly and an LDH over twice the normal limit [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Tumour Lysis Syndrome in Mantle Cell Lymphoma: A Case Study

Taha¹,

Bhaskar²

2022

Cureus

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Tumour lysis syndrome (TLS) is an onco-metabolic emergency seen in rapidly proliferative malignancies resulting from the destruction of tumour cells, resulting in an electrolyte and metabolic derangement. TLS is usually associated with high-grade haematological malignancies and rarely with solid tumours. TLS can be therapy induced or might occur spontaneously. Here, we present a case of a 61-year-old male patient with newly diagnosed mantle cell lymphoma (MCL) admitted for elective chemotherapy, who went into sudden spontaneous tumour lysis before the administration of cytotoxic chemotherapy. The laboratory investigations were consistent with hyperkalaemia, hyperuricaemia, hyperphosphatemia and acute kidney injury. The patient was managed with aggressive intravenous hydration and rasburicase, and his hyperkalaemia was managed in the ward. He was taken to the intensive care unit (ICU) for consideration of haemofiltration. Unfortunately, the patient went into multi-organ failure soon after and died. This case emphasises the need to recognise and treat this complication quickly as it can have fatal consequences. Additionally, it stresses the necessity to vigorously screen patients admitted with malignancy and high tumour burden for TLS, even when they do not receive cytotoxic treatment. TLS management includes adequate hydration, the use of uric acid-lowering therapies and minimisation of potassium intake.

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“…These cases might have the host-related extrinsic factors. Some cases have been reported to be caused by host-related factors such as proceeding infection [ 29 ], the contrast dye iohexol [ 30 ], operations [ 31 ], and even anesthesia [ 32 ]. Our case has no apparent coexisting risks and we finally diagnosed her as having spontaneous TLS.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Tumor Lysis Syndrome in a Patient with a Dedifferentiated Endometrial Adenocarcinoma

Harada¹,

Nagaharu

Baba³

et al. 2017

Case Reports in Oncological Medicine

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Tumor lysis syndrome (TLS) is an oncological emergency caused by massive cytolysis of malignant cells. This syndrome eventually induces metabolic abnormalities. TLS is observed mainly among tumors with rapid cell proliferation or high sensitivity to antineoplastic treatment. In rare cases, TLS occurs without any cytotoxic treatment. Previous reports have shown that alternative stress including proceeding infection or an operation might play a role in TLS. However, exact mechanism of spontaneous TLS remains unknown. Here, we describe a case of a 59-year-old woman who presented with dedifferentiated endometrial adenocarcinoma and developed TLS without any cytotoxic chemotherapy. Although spontaneous TLS in solid malignancies are extremely rare, clinicians should consider the possibilities of TLS especially in aggressive solid tumors.

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Spontaneous tumour lysis syndrome associated with contrast dye iohexol use in mantle cell lymphoma

Cited by 6 publications

References 30 publications

Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase

Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase

Spontaneous Tumour Lysis Syndrome in Mantle Cell Lymphoma: A Case Study

Spontaneous Tumor Lysis Syndrome in a Patient with a Dedifferentiated Endometrial Adenocarcinoma

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