scholarly journals Spontaneous Tumor Lysis Syndrome in Blastoid-Variant Mantle Cell Lymphoma: Considerations for the General Internist

2020 ◽  
Vol 8 ◽  
pp. 232470962094470 ◽  
Author(s):  
Vishal Patel ◽  
Robert Case
Keyword(s):  
Uric Acid ◽  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Tumor Lysis Syndrome ◽  
General Internist ◽  
Tumor Lysis ◽  
Spontaneous Tumor ◽  
Mantle Cell ◽  
Spontaneous Tumor Lysis Syndrome

Spontaneous tumor lysis syndrome (SPTLS) is a rare phenomenon that can manifest in rapidly proliferating hematological malignancies and solid tumors prior to initiating cytotoxic therapy. We encountered a patient who originally presented with diffuse lymphadenopathy, abdominal distention, and dyspnea, who had laboratory abnormalities suggestive of SPTLS. His peripheral flow cytometry and lymph node biopsy revealed blastoid-variant mantle cell lymphoma. Prior to initiating chemotherapy, acute kidney injury (AKI) and uric acid had improved with intravenous fluids and the initiation of allopurinol. However, after beginning chemotherapy, the patient developed a second AKI concerning for tumor lysis syndrome (TLS). He went on to have renal recovery and did not require renal replacement therapy. With the exception of case reports, there is limited evidence to guide general medicine clinicians who encounter cases of SPTLS. Expert-based guidelines are available to guide use of rasburicase, an uricase enzyme, before initiation of chemotherapy for certain malignancies when risk for TLS is considered high. Despite these guidelines, the role of rasburicase in preventing AKI remains controversial after inconclusive results in a meta-analysis. The causative relationship between uric acid and AKI in TLS is based on a mechanism of tubular obstruction. There are also mechanisms by which uric acid may cause AKI without tubular obstruction related to acute hyperuricemic nephropathy. Further characterization of the role of uric acid in causing AKI in patients without tubular obstruction may identify new mechanisms of injury and offer insight into new treatment strategies.

Revised Dose Ramp-Up to Mitigate the Risk of Tumor Lysis Syndrome When Initiating Venetoclax in Patients With Mantle Cell Lymphoma

2018 ◽  
Vol 36 (35) ◽  
pp. 3525-3527 ◽  
Author(s):  
Matthew S. Davids ◽  
Gottfried von Keudell ◽  
Craig A. Portell ◽  
Jonathon B. Cohen ◽  
David C. Fisher ◽  
...  
Keyword(s):  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Tumor Lysis Syndrome ◽  
Tumor Lysis ◽  
Mantle Cell

scholarly journals Spontaneous Tumor Lysis Syndrome in the Setting of B-Cell Lymphoma

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Mateusz Opyrchal ◽  
Travis Figanbaum ◽  
Amit Ghosh ◽  
Vincent Rajkumar ◽  
Sean Caples
Keyword(s):  
Cell Lymphoma ◽  
Early Recognition ◽  
Tumor Lysis Syndrome ◽  
Delayed Diagnosis ◽  
B Cell Lymphoma ◽  
Tumor Cell Death ◽  
Tumor Lysis ◽  
Spontaneous Tumor ◽  
Underlying Malignancy ◽  
Spontaneous Tumor Lysis Syndrome

Tumor lysis syndrome (TLS) presenting in absence of chemotherapy is a rare occurrence. One of the true oncological emergencies, it can lead to significant morbidity and mortality. TLS is a phenomena usually associated with tumor cell death after treatment. The etiology of the spontaneous TLS is not well understood, which complicates the diagnosis. TLS is well known to oncologists but physicians outside of this specialty have little or no experience with this condition. Early recognition and treatment are the keys to limiting the sequela of the condition. Spontaneous tumor lysis syndrome is rare but presents added risks to the patient because of the potential for delayed diagnosis and no benefit of pretreatment. Diagnosis may be further delayed because this may be the first symptom of underlying malignancy. Therefore, it is imperative that all clinicians are familiar with the syndrome to assure timely recognition.

scholarly journals Spontaneous tumor lysis syndrome in a patient with newly diagnosed metastatic colonic adenocarcinoma

CJEM ◽  
2017 ◽  
Vol 20 (S2) ◽  
pp. S41-S43 ◽  
Author(s):  
Ross Berringer
Keyword(s):  
Uric Acid ◽  
Tumor Lysis Syndrome ◽  
Hematologic Malignancies ◽  
Colonic Adenocarcinoma ◽  
Newly Diagnosed ◽  
Cytotoxic Therapy ◽  
Tumor Lysis ◽  
Spontaneous Tumor ◽  
Spontaneous Tumor Lysis Syndrome

AbstractAcute tumor lysis syndrome in the absence of cytotoxic therapy is an uncommon event but has been reported with hematologic malignancies. The case described below illustrates spontaneous tumor lysis syndrome in the context of a rapidly proliferating metastatic colonic adenocarcinoma. Clinicians should consider ordering phosphate, uric acid, and calcium when assessing patients with recently diagnosed or suspected malignancy.

Ibrutinib-associated tumor lysis syndrome in chronic lymphocytic leukemia/small lymphocytic lymphoma and mantle cell lymphoma: A case series and review of the literature

2017 ◽  
Vol 24 (7) ◽  
pp. 544-549 ◽  
Author(s):  
Krystal S Titus-Rains ◽  
Jamie N Brown ◽  
Julia M Hammond
Keyword(s):  
Adverse Drug Reaction ◽  
Chronic Lymphocytic Leukemia ◽  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Tumor Lysis Syndrome ◽  
Case Series ◽  
Lymphocytic Leukemia ◽  
Small Lymphocytic Lymphoma ◽  
Tumor Lysis ◽  
Mantle Cell

Background Tumor lysis syndrome results when intracellular contents are released during cell lysis. Ibrutinib, a Bruton tyrosine kinase inhibitor, is used for the treatment of chronic lymphocytic leukemia, small lymphocytic lymphoma, Waldenström’s macroglobulinemia, mantle cell lymphoma, and marginal zone lymphoma. Tumor lysis syndrome caused by ibrutinib therapy is potentially life threatening, but is rare and not often reported in clinical trials. Objective The purpose of this case series is to describe the occurrence of tumor lysis syndrome in two patients initiated on ibrutinib, and to highlight the importance of close monitoring during therapy. Discussion One patient with chronic lymphocytic leukemia/small lymphocytic lymphoma and one patient with mantle cell lymphoma developed laboratory and clinical tumor lysis syndrome following initiation of ibrutinib therapy. Assessment with the Naranjo Adverse Drug Reaction Probability Scale indicated one probable relationship and one possible relationship between ibrutinib therapy and tumor lysis syndrome. There were additional factors that may have confounded the laboratory and clinical factors observed, including baseline laboratory values and concurrent medications. Both patients were managed with supportive therapies. A literature review identified five additional reported cases of tumor lysis syndrome following ibrutinib therapy. Conclusion This case series identifies one patient with a probable relationship and one patient with a possible relationship between the development of tumor lysis syndrome and treatment with ibrutinib. Although uncommon, proper attention should be given to monitoring for this adverse drug reaction and appropriate follow-up should occur despite ibrutinib’s ease of administration.

Ibrutinib-associated tumor lysis syndrome in a patient with mantle cell lymphoma: A case report

2016 ◽  
Vol 23 (3) ◽  
pp. 235-239 ◽  
Author(s):  
Varinder Kaur ◽  
Arjun Swami
Keyword(s):  
Mantle Cell Lymphoma ◽  
Kinase Inhibitor ◽  
Cell Lymphoma ◽  
Rare Complication ◽  
Tumor Lysis Syndrome ◽  
B Cell Lymphoma ◽  
Tumor Lysis ◽  
Mantle Cell ◽  
Hodgkin's Lymphomas

Mantle cell lymphoma accounts for 5–7% of all non-Hodgkin’s lymphomas. Under the current WHO classification, it is categorized as an indolent B cell lymphoma, but has an aggressive clinical course. New insights into leukemogenic molecular pathways of mantle cell lymphoma have uncovered unique therapeutic targets. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, is the newest drug in the arsenal that has shown promising efficacy in relapsed mantle cell lymphoma. Long-term studies have shown that grade 3 or 4 adverse events are infrequent. Asymptomatic lymphocytosis is frequently seen with ibrutinib use in mantle cell lymphoma; however, tumor lysis syndrome is an extremely rare complication. To date, only two patients with ibrutinib-associated tumor lysis syndrome in mantle cell lymphoma have been described in a long-term follow-up study. Both patients met laboratory criteria for tumor lysis syndrome, however, but did not develop clinical tumor lysis syndrome. We, here describe a patient with relapsed mantle cell lymphoma who developed clinical tumor lysis syndrome with ibrutinib monotherapy.

Spontaneous tumor lysis syndrome in a patient with diffuse large B cell lymphoma and Richter syndrome

2005 ◽  
Vol 85 (3) ◽  
pp. 183-184 ◽  
Author(s):  
Abdurrahman Tufan ◽  
Nese Unal ◽  
Ebru Koca ◽  
Ibrahim Onal ◽  
Salih Aksu ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Tumor Lysis Syndrome ◽  
B Cell Lymphoma ◽  
Tumor Lysis ◽  
Spontaneous Tumor ◽  
Large B Cell Lymphoma ◽  
Richter Syndrome ◽  
Spontaneous Tumor Lysis Syndrome ◽  
Large B Cell

scholarly journals Spontaneous tumor lysis syndrome in diffuse large B-cell lymphoma patient as a cause of acute kidney injury

Oncoreview ◽  
2021 ◽  
Vol 11 (1(41)) ◽  
pp. 22-26
Author(s):  
Przemysław Kwiatkowski ◽  
Grzegorz Kade ◽  
Janusz Hałka
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Tumor Lysis Syndrome ◽  
B Cell Lymphoma ◽  
Neoplastic Disease ◽  
Tumor Lysis ◽  
Spontaneous Tumor ◽  
Large B Cell Lymphoma ◽  
Spontaneous Tumor Lysis Syndrome ◽  
Large B Cell

Idiopathic tumor lysis syndrome is a rare complication in the course of neoplastic disease. This condition requires an interdisciplinary therapeutic procedure. The presented case of spontaneous tumor lysis syndrome in the course of malignant large B-cell lymphoma describes an effective therapeutic approach in this type of cases.

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