title: High Risk of Tumor Lysis Syndrome in Symptomatic Patients with Multiple Myeloma with Renal Dysfunction Treated with Bortezomib.
abstract: Tumor lysis syndrome (TLS) is a life-threatening complication associated with cancer chemotherapy. We retrospectively evaluated the risk of developing TLS in patients with symptomatic multiple myeloma undergoing chemotherapy.
  
  
  
  Sixty-four patients (median age=71 years, range=48-87 years, 35 males/29 females) who were treated at our Institution between April 2006 and December 2015 were evaluated.
  
  
  
  A total of 124 chemotherapy courses were administered, of which 63 courses were bortezomib-based regimens and 34 courses were immunomodulatory drug (IMiD)-based regimens. TLS occurred in 13 (10.5%) out of 124 chemotherapy courses with five (4.0%) cases of laboratory TLS and eight (6.5%) cases of clinical TLS. The incidences of TLS were 17.5% for bortezomib-containing regimens and 3.2% for non-bortezomib-based regimens. No TLS occurred in the patients treated with IMiD-containing regimens. TLS occurred more frequently in the patients with elevated uric acid, creatinine, or beta-2-microglobulin levels at baseline. The patients with disease classified as advanced International Staging System also developed TLS more frequently. All the patients who developed clinical TLS received bortezomib-containing regimens (8/63, 12.7%). Among them, patients with elevated values of uric acid or creatinine developed clinical TLS more often than those without such elevation. The incidence of clinical TLS was 33.3% if the patients had renal dysfunction at baseline and were subsequently treated with bortezomib-based regimens (8/24 cases).
  
  
  
  Patients with renal dysfunction or a high uric acid level receiving bortezomib-based chemotherapy have a high risk of developing TLS.
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Oiwa
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Morita
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan skishi@u-fukui.ac.jp.|Department of Health and Nutrition, Faculty of Human Life Studies, Jin-ai University, Fukui, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kishi
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Okura
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Tasaki
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Matsuda
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Tai
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Hosono
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Ueda
authors.affiliation: Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamauchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000069286:Bortezomib / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D015275:Tumor Lysis Syndrome / Q000209:etiology*
chemical_list: D000069286:Bortezomib
keywords: Tumor lysis syndrome; bortezomib; renal dysfunction; symptomatic myeloma