[Tumor lysis syndrome at the induction therapy of the first remission in two cases of T-ALL].
The anti-tumor therapy followed by tumor lysis syndrome may cause the metabolic disorders including hyperkalemia, hyperphosphatemia and hyperuricemia. It should be known that it occurs frequently in lymphoproliferative diseases, especially in Burkitt's lymphoma. Two cases of T-ALL accompanied by this syndrome, from which the patients were recovered, at the induction therapy of the first complete remission are reported here. Case 1. A 28-year-old man received VP therapy under the diagnosis of T-ALL with massive hepatosplenomegaly and bilateral enlarged kidneys. During the therapy, metabolic disorders with both renal failure and ventricular tachycardia happened. They were resolved by certain series of treatments. The patient was brought to a complete remission with normal size of liver, spleen and kidneys. Case 2. A boy aged 15 having received the intrasubarachnoidal infusion of MTX and 1-Ad-VP therapy under the diagnosis of T-ALL accompanied by this syndrome which was improved by an appropriate treatment, and the patient was lead to the remission. The risk factors of this syndrome, such as 1-high drug sensitivity of the tumor; 2-renal dysfunction; 3-rapid cytokinetics of the tumor cell; 4-bigger size of the tumor, as well as the preventive treatment of this syndrome are reviewed.
Third Dept. of Internal Medicine, Hokkaido University Hospital.
M
M
Akiba
Y
Y
Kunieda
S
S
Maeda
M
M
Oita
M
M
Okabe
I
I
Maekawa
T
T
Miyazaki
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D004317:Doxorubicin / Q000009:adverse effects; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy*; D008297:Male; D011239:Prednisolone / Q000009:adverse effects; D011241:Prednisone / Q000009:adverse effects; D012074:Remission Induction; D015275:Tumor Lysis Syndrome / Q000209:etiology*; D014750:Vincristine / Q000009:adverse effects
D014750:Vincristine; D004317:Doxorubicin; D011239:Prednisolone; D011241:Prednisone