295 Acute Kidney Injury from Tumor Lysis Syndrome Associated with Ipilimumab/Nivolumab Therapy

2020 ◽  
Vol 75 (4) ◽  
pp. 621 ◽  
Keyword(s):  
Acute Kidney Injury ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Tumor Lysis

scholarly journals Tumor Lysis Syndrome Management in Community Oncology Settings

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5875-5875
Author(s):  
Scott Howard
Keyword(s):  
Acute Kidney Injury ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Research Network ◽  
Newly Diagnosed ◽  
Bulky Disease ◽  
Tumor Lysis ◽  
Lowering Therapy ◽  
Community Oncology ◽  
The Guardian

Background Tumor lysis syndrome (TLS) can complicate the management of patients with bulky chemosensitive cancers. TLS incidence and severity are increasing with new highly effective agents for hematologic cancers. However, prophylaxis and management vary widely, even within the same center. Methods We examined TLS management and outcomes from records of 14383 newly-diagnosed adults with lymphoma treated from 2010- 2019 at 110 member hospitals of the Guardian Research Network (GRN, www.GuardianResearch.org), a non-profit community oncology consortium with a database containing patients' entire medical, including all demographics, diagnoses, labs, medications, procedures, encounters, and notes of all kinds (clinical, radiology reports). Anonymized, de-identified data about demographics, diagnosis, treatment, supportive care, and outcomes was analyzed to determine patterns of TLS management in the community setting. Natural language processing was used to identify clinicians' references to tumor lysis syndrome, risk assessment, and cancer bulk. Results Of 529784 cancer patients in the Guardian Research Network database, there were 14383 newly-diagnosed adults with lymphoma, of whom 81% received no uric acid lowering therapy, 17% received allopurinol or febuxostat, and only 2% received Rasburicase. TLS management varied by region: 11% of patients in Virginia received uric acid lowering therapy vs 26% in South Carolina (p<0.001) and lymphoma subtype: 11% Hodgkin lymphoma, 26% B-cell non-Hodgkin lymphomas, p<0.001). Acute kidney injury (AKI) occurred in 4.3% of patients and logistic regression confirmed NHL (versus Hodgkin), black race (versus white), and older age as risk factors (p<0.01 for each). 216 patients (1.5%) died within 30 days. Of special note, bone marrow infiltration in acute leukemia patients was not noted as a site of bulky disease, despite the fact that a marrow with 50% infiltration of leukemic cells typically contains 700 grams of cancer, and represents bulky disease that places the patient at significant risk for TLS if treated with highly active agents. Conclusions Early acute kidney injury is common in patients with B-cell lymphomas. Assessment of TLS risk and prophylaxis is warranted, especially when using new, highly effective chemotherapy agents in patients with bulky disease. Assessment of tumor bulk was rarely documented in the medical records. Table Disclosures Howard: BTG: Consultancy, Research Funding; EUSA Pharma: Consultancy; Sanofi: Consultancy, Speakers Bureau; Servier: Consultancy, Speakers Bureau; Amgen: Honoraria.

1151: Safety and Efficacy of Renal Replacement Therapy for Acute Kidney Injury in Tumor Lysis Syndrome

2020 ◽  
Vol 49 (1) ◽  
pp. 577-577
Author(s):  
Sidra Ishaque ◽  
Anwar Haque ◽  
Abdul Rahim Ahmed ◽  
Farhana Amanullah ◽  
Faiza Rehman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Safety And Efficacy ◽  
Tumor Lysis

Acute kidney injury associated with tumor lysis syndrome: a paradigm shift

2012 ◽  
Vol 30 (2) ◽  
pp. 390.e3-390.e6 ◽  
Author(s):  
Amr El-Husseini ◽  
Alberto Sabucedo ◽  
Jorge Lamarche ◽  
Craig Courville ◽  
Alfredo Peguero
Keyword(s):  
Acute Kidney Injury ◽  
Paradigm Shift ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Tumor Lysis

scholarly journals P0568INCIDENCE AND RISK FACTORS OF ACUTE KIDNEY INJURY AND TUMOR LYSIS SYNDROME IN PATIENTS WITH MULTIPLE MYELOMA TREATED WITH BORTEZOMIB

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
SEUNGMIN SONG ◽  
Hyo jin Boo ◽  
Hye Ryoun Jang ◽  
Wooseong Huh ◽  
Dae Joong Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Acute Kidney Injury ◽  
High Risk ◽  
Multivariate Analyses ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Renal Amyloidosis ◽  
Tumor Lysis ◽  
Β2 Microglobulin

Abstract Background and Aims Nephrotoxicity of bortezomib, a proteasome inhibitor, has not yet been described frequently, while tumor lysis syndrome (TLS) associated with multiple myeloma (MM) has been increased after introduction of the drug. This study compared the incidence and risk factors of acute kidney injury (AKI) and TLS in patients with MM after bortezomib-based chemotherapy to investigate the drug-related nephrotoxicity. Method From 2006 to 2017, 276 patients who underwent first cycle of bortezomib-based chemotherapy for MM were identified in single tertiary hospital. Laboratory TLS was defined according to the Cairo-Bishop definition. Development of AKI was assessed by AKI Network (AKIN) criteria within 7 days after first chemotherapy. Results The age was 65 [56-72] years old, and 47% (n=131) of participants were female and baseline estimated glomerular filtration rate (eGFR) was 61.3 [34.1-89.1] mL/min/1.73m2. The incidences of AKI and laboratory TLS were 17% (n=47) and 13% (n=36), respectively. Ten (3.6%) subjects corresponded to the both AKI and TLS criteria. Multivariate analyses showed that lower eGFR category (30∼59, odds ratio [OR]=3.063 [1.278-7.339]; 15∼29, OR=3.417 [1.088-10.726]; &lt;15, OR=10.080 [2.677-37.951] vs ≥ 60), lower serum albumin level (OR=0.491 [0.278-0.868], P=0.0144) and renal amyloidosis (OR=11.174 [3.974-31.420], P&lt;0.0001) were predictors of development of AKI. MM stages and β2-microglobulin were not associated with AKI occurrence. Regarding laboratory TLS, MM stage and β2-microglobulin were higher in those with TLS. In multivariate analyses, β2-microglobulin levels (OR=1.194 [1.066-1.337], P=0.0021) and any chromosomes abnormalities at high risk (OR=0.115 [0.026-0.503], P=0.0041) were associated with higher risk of TLS. Conclusion Development of AKI was often observed without being accompanied by TLS in patients with MM after treatment of bortezomib. In addition, risk factors of AKI and TLS were widely different. These findings implicated the potential nephrotoxicity of bortezomib besides TLS in patients with decreased kidney function. The efforts to prevent bortezomib associated AKI are needed in patients at high risk.

Severe hyperuricemia with acute kidney injury: Vigilance needed for spontaneous tumor lysis syndrome

2015 ◽  
Vol 4 (3-4) ◽  
pp. 41-43 ◽  
Author(s):  
Mohan P. Patel ◽  
Vivek B. Kute ◽  
Himanshu V. Patel ◽  
Pankaj R. Shah ◽  
Hargovind L. Trivedi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Tumor Lysis ◽  
Spontaneous Tumor ◽  
Spontaneous Tumor Lysis Syndrome

scholarly journals Spontaneous Tumour Lysis Syndrome in a Multiple Myeloma

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Can Huzmeli ◽  
Eylem Eliacik ◽  
Mustafa Saglam ◽  
Baris Doner ◽  
Ferhan Candan
Keyword(s):  
Multiple Myeloma ◽  
Acute Kidney Injury ◽  
Uric Acid ◽  
Metabolic Acidosis ◽  
Tumor Lysis Syndrome ◽  
Laboratory Data ◽  
Compression Fracture ◽  
Kidney Injury ◽  
Metabolic Abnormalities ◽  
Tumor Lysis

The tumor lysis syndrome (TLS) is a collection of metabolic abnormalities that occur in consequence of the release of intracellular contents following lysis of tumor cells. TLS occurs spontaneously or after chemotherapy. Spontaneous TLS is uncommon occurrence in multiple myeloma (MM). We define a case of a 70-year-old woman patient who was found to have MM with spontaneous TLS, following a compression fracture of the T-12 vertebrae. While serum uric acid and phosphorous levels were high, low calcium levels were identified. There were also acute kidney injury and metabolic acidosis. Upon the diagnosis of TLS, she was treated with hydration, allopurinol, sodium bicarbonate, and calcium gluconate. The improvement of her laboratory data was observed. We submitted this case in order to draw attention to the presentation of MM with spontaneous TLS.

Fluid overload and acute kidney injury in children with tumor lysis syndrome

2021 ◽  
Author(s):  
Kayla Flood ◽  
Jacob Rozmus ◽  
Peter Skippen ◽  
Douglas G. Matsell ◽  
Cherry Mammen
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Overload ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Tumor Lysis

scholarly journals Chronic lymphocytic leukemia; an incidental finding in a COVID-19 patient.

2021 ◽  
Author(s):  
Shazaf Masood Sidhu ◽  
Fabiha Ghulam Muhammad ◽  
Ainan Arshad
Keyword(s):  
Acute Kidney Injury ◽  
Chronic Lymphocytic Leukemia ◽  
Incidental Finding ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Functional Class ◽  
Lymphocytic Leukemia ◽  
Shortness Of Breath ◽  
Tumor Lysis ◽  
History Of

Abstract We report a case of 57 years old male, with no prior comorbids functional class I, presented with a history of fever for one week along with shortness of breath and cough for 5 days. Upon workup his baseline CBC reported bicytopenia along with marked lymphocytosis which raised the suspicion and to confirm the diagnosis, his acute leukemia comprehensive panel was done which reported an incidental finding of Chronic lymphocytic leukemia along with concomitant COVID PCR positive. This patient also presented with Tumor Lysis Syndrome and Acute kidney Injury.

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