Tumor cell lysis syndrome resulting from transient abnormal myelopoiesis in a neonate with Down’s syndrome

Abstract

Newborns with Down's syndrome occasionally present with transient proliferation of blasts, designated as transient abnormal myelopoiesis (TAM) 1 or transient myeloproliferative disorder. The blasts have monoclonality and a megakaryocyte nature with the capacity to differentiate towards multilineage blood cells. 2 The disorder is assumed to be different from 'true malignancy', because the disease regresses spontaneously. However several complications, including hyperviscosity syndrome, hemorrhage and liver fibrosis, have been described and the prognosis is not always favorable. [3][4][5] Acute tumor cell lysis syndrome (ATLS) is a metabolic disorder characterized by hyperkalemia, hyperuricemia and hyperphosphatemia, which results from rapid degradation of malignant cells after initiation of effective chemotherapy. 6 In the present study, we report on a case with TAM, who developed ATLS without any cytotoxic therapies.

Transient abnormal myelopoiesis complicated by tumor lysis syndrome

“…There are few reports of TLS associated with TAM. Kato et al reported one patient with TAM who developed TLS 6 . The present case was complicated by acute renal failure, which was induced by asphyxia.…”

“…The most commonly associated malignancies are non‐Hodgkin’s lymphoma and acute lymphocytic leukemia 4,5 . TLS is rarely reported in association with TAM 6 …”

Acknowledgments

“…Kato et al reported one patient with TAM who developed TLS. 6 The present case was complicated by acute renal failure, which was induced by asphyxia. However, blood chemistry fi ndings revealed increasing levels of serum IP, potassium and UA together with a decrease in the number of blasts.…”

Transient myeloproliferative disorder in a newborn with down syndrome treated with rasburicase for the risk of development of tumor lysis syndrome: A case report

“…These metabolic complications include hyperkalemia, hyperphosphatemia, hyperuricemia and hyperuricosuria, hypocalcemia, and consequent acute uric acid nephropathy and acute renal failure [7]. There are only few reports of TLS associated with TMD [10,11]. Abe et al .…”

“…Kato et al . reported the case of a baby with DS who developed TLS as a result of TMD, successfully treated with allopurinol and diuretics [10]. …”