Efficacy of continuous venovenous hemofiltration with chemotherapy in patients with Burkitt lymphoma and leukemia at high risk of tumor lysis syndrome.
Tumor lysis syndrome (TLS) is a potentially fatal metabolic complication of chemotherapy for Burkitt lymphoma. It has not been established whether chemotherapy should be delayed in patients with spontaneous TLS, and several studies have shown poor prognoses in this group. This retrospective study evaluated the efficacy and safety of continuous venovenous hemofiltration (CVVH) with prephase chemotherapy using the modified LMB-89 regimen in patients with Burkitt lymphoma and leukemia (BL/L) at a high risk of developing TLS from February 1998 to February 2007. The chemotherapy regimen was followed by the modified LMB-89 protocol. CVVH was applied to all patients before prephase chemotherapy or within 2 h of chemotherapy. The median follow-up was 19.7 months (range 1-97.8). Eight patients had Burkitt lymphoma and three had Burkitt leukemia; their median age was 48 years. The international prognostic indices were >3 for all patients. Seven patients had spontaneous TLS and four patients were at a high risk of TLS. CVVH was continued for 109 h (range 70.5-157.5). No patient had fatal metabolic complications related to TLS. Renal function had recovered fully before induction chemotherapy in all but one patient. The 1-year event-free survival and overall survival rates were both 82%. In conclusion, chemotherapy combined with CVVH might be effective and safe in patients with advanced Burkitt lymphoma and leukemia at a high risk of developing TLS.
Choi
Kyung A
KA
Division of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-Gu, Seoul, South Korea.
Lee
Jung Eun
JE
Kim
Yoon-Goo
YG
Kim
Dae Joong
DJ
Kim
Kihyun
K
Ko
Young Hyeh
YH
Oh
Ha Young
HY
Kim
Won Seog
WS
Huh
Wooseong
W
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use* / Q000633:toxicity; D002051:Burkitt Lymphoma / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D033461:Hyperuricemia; D007677:Kidney Function Tests; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D016019:Survival Analysis; D015275:Tumor Lysis Syndrome / Q000209:etiology*; D014750:Vincristine / Q000008:administration & dosage
D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D002955:Leucovorin; D011241:Prednisone; D006854:Hydrocortisone; D008727:Methotrexate