title: Spontaneous tumour lysis syndrome secondary to the transformation of chronic myelomonocytic leukaemia into acute myeloid leukaemia.
abstract: A 78-year-old man, with a 6-year history of stable chronic myelomonocytic leukaemia (CMML), presented with general deterioration and worsening pancytopenia. Bone marrow biopsy showed that his disease had transformed into acute myeloid leukaemia (AML). He was started on a supportive transfusion regimen and did not receive any chemotherapy or corticosteroids. Several weeks later, he developed acute renal failure and was admitted to a medical admissions ward. Spontaneous tumour lysis syndrome (sTLS, grade 1) was diagnosed, as per the Cairo and Bishop criteria. He was treated with intravenous fluids, rasburicase and allopurinol. His renal function improved and he recovered from the sTLS. The authors believe that this is the first published case of sTLS occurring as a result of CMML transforming into AML; it highlights the importance of recognising sTLS as a cause of renal failure and electrolyte disturbance before cancer treatment begins.
authors.affiliation: Department of Haematology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: Alexander
authors.initials: A
authors.lastname: Langridge
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Kathryn
authors.identifier: http://orcid.org/0000-0003-4984-475X
authors.initials: K
authors.lastname: Musgrave
authors.affiliation: Gateshead Health NHS Foundation Trust, Gateshead, UK.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Upadhye
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D017809:Fatal Outcome; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D015477:Leukemia, Myelomonocytic, Chronic / Q000150:complications*; D008297:Male; D010198:Pancytopenia / Q000150:complications; D015275:Tumor Lysis Syndrome / Q000209:etiology* / Q000473:pathology