Tumour lysis syndrome

Akasheh MS, Chang CP, Vesole DH. Acute tumour lysis syndrome a case in AL amyloidosis. Br J Haematol 1999 107(2) 387. 

PLATINUM COMPOUNDS RITUXIMAB t risk of severe renal failure Uncertain possibly due to effects of tumour lysis syndrome (which is a result of a massive breakdown of cancer cells sensitive to chemotherapy). Features include hyperkalaemia, hyperuricaemia, hyperphosphataemia and hypocalcaemia Monitor renal function closely. Hydrate with at least 2 L of fluid before, during and after therapy. Monitor potassium and magnesium levels in particular and correct deficits. Do an ECG as arrhythmias may accompany tumour lysis syndrome... 

Fludarabine Nausea and vomiting Bone nnarrow depression CNS effects visual disturbances renal damage with higher doses pulmonary infiltrates tumour lysis syndrome (profound immunosuppression)... 

Tumour lysis syndrome - caused by death of many cells in a tumour, includes high levels of uric acid... 

Renal disease is a eommon complication of hyperuricaemia. Several types of renal disease have been identified. The most comnutn is urate nephropathy which is caused by the deposition of urate crystals in renal tissue or the urinary tract to form urate stones. This mtiy be associated with chronic hyperuricaemia. Acute renal failure can be cau.sed by the rapid precipitation of uric acid crystals w hich commonly occurs during treatment of patients with leukaemias and lymphomas. In the acute tumour lysis syndrome (p. 129), nucleic acids are released as a result of tumour cell breakdown and arc rapidly metabolized to uric acid. 

Annemans L, et al (2003). Incidence, medical resource utilisation and costs of hyperuricemia and tumour lysis syndrome in patients with acute leukaemia and non-Hodg-kin s lymphoma in four European countries. Leukemia and Lymphoma. 44(l) 77-83. 

Haroon M, Kwong WY, Cantwell B, Walker F. A case of cetuximab-related tumour lysis syndrome in metastatic rectal carcinoma. NDT Plus 2010 3(3) 271-2. 

A 6-year-old Caucasian boy with acute lymphoblastic leukaemia was given prednisolone 60 mg/ m /day for 7 days and intravenous rasburicase 0.1 mg/kg bd in order to avoid tumour lysis syndrome. However, a few hours after administration of the second dose he became cyanosed without respiratory distress due to moderately raised concentrations of methaemoglobinemia and haemolytic anaemia [64 ]. After withdrawal of rasbicurase, the haemoglobin and methaemoglobin concentrations returned to normal. 

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