title: Fatal acute tumor lysis syndrome following intrathecal chemotherapy for acute lymphoblastic leukemia with meningeal involvement.
abstract: Acute tumor lysis syndrome (ATLS) is a well-recognized complication of systemic chemotherapy for rapidly proliferating neoplasms. ATLS has rarely occurred after intrathecal chemotherapy for the treatment of leukemia with meningeal involvement. Here, we report a case of fatal ATLS complicating intrathecal injections of methotrexate, cytarabine and hydrocortisone for acute lymphoblastic leukemia which relapsed with meningeal involvement after allogeneic stem cell transplantation. This case indicates that intrathecal chemotherapy alone may be sufficient to induce ATLS. Close monitoring and prevention of ATLS are also warranted following intrathecal chemotherapy alone.
authors.affiliation: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo. t-konuma@umin.ac.jp
authors.forename: Takaaki
authors.initials: T
authors.lastname: Konuma
authors.forename: Jun
authors.initials: J
authors.lastname: Ooi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Akira
authors.initials: A
authors.lastname: Tomonari
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.forename: Seiko
authors.initials: S
authors.lastname: Kato
authors.forename: Aki
authors.initials: A
authors.lastname: Sato
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Monma
authors.forename: Kaoru
authors.initials: K
authors.lastname: Uchimaru
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D017254:Leukemic Infiltration / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008577:Meningeal Neoplasms / Q000175:diagnosis*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D015275:Tumor Lysis Syndrome / Q000150:complications / Q000175:diagnosis* / Q000209:etiology