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Showing 2 results for Tumor Lysis Syndrome

Esfahani H,
Volume 7, Issue 2 (1-2015)
Abstract

Background: Tumor lysis syndrome caused by widespread tumor cell damage may lead to electrolyte imbalances and express as metabolic disturbance causing clinical abnormalities. Patients and Methods: All patients younger than 16 years with documented malignancy candidate for chemotherapy, in Hamedan province of Iran were enrolled. Results: Out of 69 cancer patients the laboratory form of tumor lysis syndrome was detected in 8 patients (11.6%) and its clinical form was observed in 2 patients (2.9%). Those two patients with clinical tumor lysis syndrome were treated using hydration, allopurinol, rasburicase and dialysis with good metabolic response. Conclusion: Although our sample size was limited we found a comparable prevalence of tumor lysis syndrome among our patients in comparison with previous studies. Further evaluation of the prevalence of this syndrome among Iranian cancer patients is recommended. Keywords: Tumor Lysis Syndrome, acute renal failure, oncology, childhood, metabolic, Iran.
Samin Alavi, Maryam Ebadi, Sadaf Esteghamati, Mohammad Kaji Yazdi,
Volume 8, Issue 2 (6-2016)
Abstract

Background: Tumor lysis syndrome (TLS) is a major metabolic complication in patients with malignancy after initiation of chemotherapy or spontaneously without treatment. The role of Rasburicase (a recombinant urate-oxidase enzyme) in prevention and treatment of TLS has been demonstrated in recent years. We aimed to investigate the efficacy of a single dose of rasburicase in reducing the risk of TLS in children at high risk. 
Methods: we conducted a retrospective analysis of 560 children with various malignancies in a single referral center. On the basis of the reference values previously established in our center hyperuricemia and TLS were defined. Tumor lysis syndrome development was the primary outcome. 48 children with a mean age of 7.1 years (range: 3 months to 15.8 years) developed tumor lysis syndrome. The most common malignancies were B-precursor acute lymphoblastic leukemia (ALL) (45%) followed by non-Hodgkin lymphoma (NHL) and Wilms’ tumor (each 10.4%), respectively. They received normal saline intravenously at a rate of 4-5 L/m2/day in 24-48 hours prior to initiating chemotherapy. Plasma samples were drawn to detect uric acid, calcium, phosphate, potassium, creatinine and blood urea nitrogen (BUN) 4 hours before administering a single dose of IV rasburicase (0.2 mg/kg over 30 minute). Laboratory markers were evaluated again 4 and 24 hours after administering rasburicase.
Results: All patients with diagnosis of TLS had significantly decreased uric acid levels following single dose of rasburicase except 1 patient (2.1%) (P<0.001). Mean plasma uric acid concentration before treatment was 10.0±4.2 mg/dL and 4 hours after treatment declined to 2.2±5.5 (P<0.001). Hyperphosphatemia was also detected in 43.7% of these 48 cases which significantly decreased to 16.7% (P=0.012). Plasma uric acid levels remained low one day after treatment. No side effects were detected. 
Conclusion: Rasburicase is a safe and highly effective drug in children with hyperuricemia in the setting of malignancy at risk of developing TLS. 



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