Incidence and treatment of tumor lysis syndrome in patients with acute leukemia

Acta Haematol. 1994;91(4):171-4. doi: 10.1159/000204328.

Abstract

Tumor lysis syndrome (TLS) is a complication associated with electrolyte abnormalities that is observed in patients with acute leukemia who are receiving intense doses of chemotherapy. Forty-one patients with acute leukemia were treated with high-dose combination chemotherapy and were evaluated for TLS. A grading system developed for the evaluation of these patients was applied. Grade I tumor lysis was observed in 22 patients, grade II TLS in 2 patients and grade III in 1 patient. All patients were treated with intravenous fluids, mannitol, allopurinol and in some patients, aluminum-based antacids. Treatment for TLS prior to intensive chemotherapy reduced morbidity and mortality associated with high-dose chemotherapy for acute leukemias.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allopurinol / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Blast Crisis
  • Female
  • Fluid Therapy
  • Humans
  • Leukemia / complications*
  • Leukemia / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / complications
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology
  • Leukemia, Myeloid, Acute / complications
  • Leukemia, Myeloid, Acute / drug therapy
  • Male
  • Mannitol / therapeutic use
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Remission Induction
  • Tumor Lysis Syndrome / epidemiology*
  • Tumor Lysis Syndrome / etiology
  • Tumor Lysis Syndrome / therapy*

Substances

  • Antineoplastic Agents
  • Mannitol
  • Allopurinol