Fatal acute tumor lysis syndrome following intrathecal chemotherapy for acute lymphoblastic leukemia with meningeal involvement.
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.
Konuma
Takaaki
T
Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo. t-konuma@umin.ac.jp
Ooi
Jun
J
Takahashi
Satoshi
S
Tomonari
Akira
A
Tsukada
Nobuhiro
N
Kato
Seiko
S
Sato
Aki
A
Monma
Fumihiko
F
Uchimaru
Kaoru
K
Tojo
Arinobu
A
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