Tumour lysis syndrome, case report and review of the literature

Lorigan, Paul; Woodings, P. L.; Morgenstern, G. R.; Scarffe, J. H.

doi:10.1093/oxfordjournals.annonc.a010682

Cited by 28 publications

(13 citation statements)

References 25 publications

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“…Continuous infusion rates of up to 4 to 6 L/d have been suggested. Hydration increases intravascular volume and helps correct electrolyte disturbances by diluting extracellular fluid with isotonic saline, thereby reducing serum concentrations of uric acid, phosphate and potassium (Razis et al, 1994;Lorigan et al, 1996).…”

Section: Hydrationmentioning

confidence: 99%

Tumour Lysis Syndrome: Implications for Cancer Therapy

Mika¹,

Ahmad²,

Guruvayoorappan³

2012

Asian Pacific Journal of Cancer Prevention

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Asian Pacific J Cancer Prev, 13, 3555-3560 IntroductionTumour lysis syndrome (TLS) is the development of an array of metabolic disturbances that may occur either spontaneously or in response to cancer therapies. It results when a huge number of rapidly dividing cancer cells, particularly leukemia and lymphoma, are killed or lysed by cytotoxic therapy such as chemotherapy and radiation. Normal intracellular components of cells include potassium, phosphorus and nucleic acids. These intracellular ions are present in large amounts in cancer cells as compared to those in normal cells.When malignant cells are killed by therapy they release their contents into the systemic circulation, which accumulate faster in the body than being eliminated from the body and the body's homeostatic mechanisms find it difficult to cope with. The release of these intracellular contents cause metabolic disturbances, which in turn manifest into life threatening complications such as hyperkalemia, hyperphosphotemia, hypocalcemia and hyperuricemia. Tumour lysis also releases cytokines that cause a systemic inflammatory response syndrome and often multiorgan failure (Hijiya et al., 2005;Nakamura et al., 2009;Soares et al., 2009).During the early stages, some patients do not experience any symptoms of TLS but have abnormal laboratory values, which is suggestive of its succession. Laboratory results will show high potassium, uric acid and phosphorus levels and low calcium levels in the blood.

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Section: Hydrationmentioning

confidence: 99%

Tumour Lysis Syndrome: Implications for Cancer Therapy

Mika¹,

Ahmad²,

Guruvayoorappan³

2012

Asian Pacific Journal of Cancer Prevention

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“…Allopurinol hemmt als Strukturanalogon von Hypoxanthin als kompetitiver Inhibitor die Xanthinoxidase [113]. Unter Allopurinoltherapie lässt sich auch bei Patienten mit Neoplasien eine deutliche Reduktion der Harnsäurewerte erzielen [123].…”

Section: Allopurinol Versus Uratoxidaseunclassified

“…Beim Tumorlysesyndrom wird eine orale Allopurinoldosis bis zu 800 mg/Tag empfohlen. Bei Niereninsuffizienz kumuliert der aktive Metabolit Oxypurinol, ebenfalls ein effektiver Xanthinoxidasehemmer, so dass die Dosierung von Allopurinol der Nierenfunktion angepasst werden muss [113]. [131].…”

Section: Allopurinol Versus Uratoxidaseunclassified

Tumor lysis syndrome: risk factors and treatment

Hörl

2005

Wien Klin Wochenschr

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Tumor lysis syndrome is a typical oncological complication, characterized by hyperuricemia, hyperkalemia, hyperphosphatemia with secondary hypocalcemia, acidosis and acute renal failure. it occurs particularly in patients with lymphoproliferative diseases during therapy with potent myelosuppressive substances. patients with solid tumors rarely develop a tumor lysis syndrome during anti-neoplastic therapy (chemo-, hormonal-, steroid therapy, radiotherapy). host-related (e.g. pre-existing volume depletion, hyperuricemia, acidic urine) and tumor-related (e.g. large tumor burden, tumor sensitivity to therapy, advanced stage) risk factors contribute markedly to the development of tumor lysis syndrome. prophylaxis and treatment of tumor lysis syndrome consist of adequate hydration of the patients (3 l fluid/m2/day) in order to maintain urine production of > or =100 ml/h, controlled alkalinisation (urine pH 7.0-7.5) and, if necessary, extracorporeal therapy (intermittent or continuous hemodialysis or hemodiafiltration). recombinant urate oxidase (rasburicase) reduces uric acid values by far more effectively than allopurinol. treatment with rasburicase (01.-0.2 mg/kg for 1-7 days) does not only markedly reduce the incidence of tumor lysis syndrome in patients with malignancy but also morbidity and mortality. hyperphosphate-induced acute renal failure due to intrarenal calcium phosphate precipitation may, however, occur even during rasburicase therapy

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“…TLS is a potentially fatal metabolic complication of rapidly growing tumors [4][5][6][7][8], caused by spontaneous cytolysis or by maximal tumor cell lysis, beginning a few hours after the initiation of chemotherapy, and usually persisting for 3-7 days. It is characterized by a set of metabolic disturbances, including hyperuricemia, hyperkalemia, hyperphosphatemia, secondary hypocalcemia, metabolic acidosis, and azotemia [9][10][11].…”

Section: Introductionmentioning

confidence: 99%