Incidence and treatment of tumor lysis syndrome in patients with acute leukemia.
Tumor lysis syndrome (TLS) is a complication associated with electrolyte abnormalities that is observed in patients with acute leukemia who are receiving intense doses of chemotherapy. Forty-one patients with acute leukemia were treated with high-dose combination chemotherapy and were evaluated for TLS. A grading system developed for the evaluation of these patients was applied. Grade I tumor lysis was observed in 22 patients, grade II TLS in 2 patients and grade III in 1 patient. All patients were treated with intravenous fluids, mannitol, allopurinol and in some patients, aluminum-based antacids. Treatment for TLS prior to intensive chemotherapy reduced morbidity and mortality associated with high-dose chemotherapy for acute leukemias.
Razis
E
E
Division of Neoplastic Diseases, New York Medical College, Valhalla 10595.
Arlin
Z A
ZA
Ahmed
T
T
Feldman
E J
EJ
Puccio
C
C
Cook
P
P
Chun
H G
HG
Helson
L
L
Mittelman
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D001752:Blast Crisis; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy; D008297:Male; D008353:Mannitol / Q000627:therapeutic use; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy; D012074:Remission Induction; D015275:Tumor Lysis Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*
D000970:Antineoplastic Agents; D008353:Mannitol; D000493:Allopurinol