scholarly journals Acute Tumor Lysis Syndrome: A Metabolic Emergency in Cancer Patients

2021 ◽  
Vol 14 (3) ◽  
pp. 1721-1729
Author(s):  
Giorgio Attinà ◽  
Raffaele Tepedino ◽  
Antonio Ruggiero
Keyword(s):  
Lymphoblastic Leukemia ◽  
Tumor Lysis Syndrome ◽  
Therapeutic Strategies ◽  
Chemotherapy Treatment ◽  
Cytotoxic Therapy ◽  
Tumor Lysis ◽  
Rapid Release ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Massive Cell

Tumor lysis syndrome (TLS) can be a life-threatening complication that occurs following the onset of chemotherapy treatment, most commonly in association with high-grade lymphoproliferative pathologies such as acute lymphoblastic leukemia and Burkitt lymphoma. The massive cell lysis caused by cytotoxic therapy leads to the rapid release in the blood of intracelullary products and the onset of severe metabolic and electrolytic complications (hyperkalemia, hyperphosphatemia, hypocalcemia and hyperuricemia) upto the acute renal failure. This article describes the incidence and pathophysiological basis of TLS, focusing on the new therapeutic strategies implemented over the last few years, especially with regard to the treatment of hyperuricemia. In particular, it highlights the characteristics of a recent drug, Rasburicase, as a safe and effective alternative, compared to traditional allopurinol therapy, for prophylaxis and treatment of children with hyperuricemia induced by chemotherapy.

From skin to spontaneous lysis: A case of spontaneous tumor lysis syndrome in metastatic melanoma

2017 ◽  
Vol 24 (3) ◽  
pp. 221-225 ◽  
Author(s):  
Charis G Durham ◽  
Jon Herrington ◽  
Susan Seago ◽  
Chelsea Williams ◽  
Mark H Holguin
Keyword(s):  
Metastatic Melanoma ◽  
Rare Case ◽  
Tumor Lysis Syndrome ◽  
Cytotoxic Therapy ◽  
Acute Leukemias ◽  
Tumor Lysis ◽  
Spontaneous Tumor ◽  
Life Threatening ◽  
Spontaneous Tumor Lysis Syndrome ◽  
Life Threatening Complication

Tumor lysis syndrome is a life-threatening complication that often occurs after administration of cytotoxic therapy, but rarely occurs spontaneously without chemotherapy. This vignette describes a 59-year-old male with known extensive metastatic melanoma who presented to the hospital with spontaneous tumor lysis syndrome. Most spontaneous tumor lysis cases occur in patients with acute leukemias and aggressive lymphomas; however, this rare case depicts a patient with melanoma developing tumor lysis before the administration of chemotherapy.

scholarly journals The Domino Effect-Treatment of Superior Vena Cava Obstruction Triggering Tumor Lysis Syndrome: A Case Report

2021 ◽  
Vol 3 (1) ◽  
pp. 44-50
Author(s):  
Suman Ghosh ◽  
Tilak TVSVGK ◽  
Venkatesan Somasundaram ◽  
Mutreja Deepti
Keyword(s):  
Superior Vena Cava ◽  
Lymphoblastic Leukemia ◽  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Potassium Phosphate ◽  
Successful Outcome ◽  
Superior Vena Cava Obstruction ◽  
Tumor Lysis ◽  
Life Threatening

Oncological emergencies present in a multitude of manners-structural, metabolic, hematologic, etc. affecting multiple systems, often. Urgent institution of therapy is often required for a successful outcome. Occasionally, the treatment of one emergency can initiate a related or unrelated emergency, necessitating management of all the complications simultaneously. Superior vena cava obstruction (SVCO) is a medical emergency and most often manifests in patients with a malignant disease process requiring immediate diagnostic evaluation and therapy due to its’ life threatening presentation. The management of the SVCO is usually with chemotherapy, radiotherapy or intervention. In cases of large tumor burden, management of SVCO can trigger other complications. Tumor lysis syndrome is an oncologic emergency, which is characterized by a massive release of intracellular potassium, phosphate, and nucleic acid metabolites into the systemic circulation, which can be life-threatening. We present the case of a T-cell acute lymphoblastic leukemia with superior vena cava syndrome, developing tumor lysis syndrome on instituting definitive chemotherapy in a young patient. Doi: 10.28991/SciMedJ-2021-0301-6 Full Text: PDF

scholarly journals A Case of Spontaneous Tumor Lysis Syndrome in a Patient with Ovarian Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Kazuhiro Okamoto ◽  
Toshifumi Kinoshita ◽  
Miyuki Shimizu ◽  
Isoji Okura ◽  
Akinori Kawada ◽  
...  
Keyword(s):  
Ovarian Tumor ◽  
Tumor Recurrence ◽  
Hematological Malignancies ◽  
Tumor Lysis Syndrome ◽  
Anticancer Therapy ◽  
The Novel ◽  
Chemotherapy Treatment ◽  
Tumor Lysis ◽  
Life Threatening ◽  
Spontaneous Tumor Lysis Syndrome

Tumor lysis syndrome (TLS) is a potentially life-threating complication of tumors or chemotherapy treatment. TLS commonly occurs in hematological malignancies, but it is very rare in patients with a solid tumor. In cases of solid tumors, TLS usually occurs spontaneously and after the initiation of anticancer therapy, and it has a high mortality rate. We present the novel case of a 62-year-old woman with an ovarian tumor who spontaneously developed TLS. Surgical reduction of the tumor mass vastly improved her condition. She showed no sign of tumor recurrence 8 months after treatment. As TLS is life-threatening, successful treatments must be seriously considered.

Hematologic and Oncologic Emergencies

2019 ◽  
pp. 170-177
Author(s):  
James McCue
Keyword(s):  
Emergency Department ◽  
Standardized Tests ◽  
Tumor Lysis Syndrome ◽  
Clinical Effects ◽  
Tumor Lysis ◽  
Oncologic Emergencies ◽  
First Response ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Life Threatening

Hematologic and oncologic emergencies are an uncommon reason for people to present to the emergency department (ED), but when they do, it is important to know how to diagnose and treat these conditions because many of them are life threatening. Whether it is bleeding due to conditions such as hemophilia, von Willebrand’s disease, warfarin use, or dangerous conditions related to cancer such as tumor lysis syndrome or neutropenic fever, knowing the basics will help you manage these patients and also ace the standardized tests. This chapter presents questions related to the diagnosis, clinical effects, best first response in the ED, and most appropriate treatment of a wide range of these hematologic and oncologic emergencies.

Myocardial calcification in a patient with B-lymphoblastic leukemia accompanied by tumor lysis syndrome

2019 ◽  
Vol 43 ◽  
pp. 107146 ◽  
Author(s):  
Genki Usui ◽  
Hirotsugu Hashimoto ◽  
Yusuke Uchibori ◽  
Kensuke Usuki ◽  
Hajime Horiuchi ◽  
...  
Keyword(s):  
Lymphoblastic Leukemia ◽  
Tumor Lysis Syndrome ◽  
Tumor Lysis ◽  
Myocardial Calcification

scholarly journals Prevention and Treatment of Tumor Lysis Syndrome in the Era of Onco-Nephrology Progress

2020 ◽  
Vol 45 (5) ◽  
pp. 645-660
Author(s):  
Joanna Matuszkiewicz-Rowinska ◽  
Jolanta Malyszko
Keyword(s):  
High Risk ◽  
Treatment Plan ◽  
Diuretic Therapy ◽  
Tumor Lysis Syndrome ◽  
Phosphate Binders ◽  
Tumor Lysis ◽  
Threatening Condition ◽  
Clinical Consequences ◽  
Life Threatening ◽  
Knowledge Of Cancer

Background: Tumor lysis syndrome (TLS) is an oncologic emergency due to a rapid break down of malignant cells usually induced by cytotoxic therapy, with hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and serious clinical consequences such as acute renal injury, cardiac arrhythmia, hypotension, and death. Rapidly expanding knowledge of cancer immune evasion mechanisms and host-tumor interactions has significantly changed our therapeutic strategies in hemato-oncology what resulted in the expanding spectrum of neoplasms with a risk of TLS. Summary: Since clinical TLS is a life-threatening condition, identifying patients with risk factors for TLS development and implementation of adequate preventive measures remains the most critical component of its medical management. In general, these consist of vigilant laboratory and clinical monitoring, vigorous IV hydration, urate-lowering therapy, avoidance of exogenous potassium, use of phosphate binders, and – in high-risk cases – considering cytoreduction before the start of the aggressive agent or a gradual escalation of its dose. Key Messages: In patients with a high risk of TLS, cytotoxic chemotherapy should be given in the facility with ready access to dialysis and a treatment plan discussed with the nephrology team. In the case of hyperkalemia, severe hyperphosphatemia or acidosis, and fluid overload unresponsive to diuretic therapy, the early renal replacement therapy (RRT) should be considered. One must remember that in TLS, the threshold for RRT initiation may be lower than in other clinical situations since the process of cell breakdown is ongoing, and rapid increases in serum electrolytes cannot be predicted.

Recommendation of the Surgical Option for Treatment of Encapsulating Peritoneal Sclerosis

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 205-210 ◽  
Author(s):  
Hideki Kawanishi ◽  
Misaki Moriishi ◽  
Kentaro Ide ◽  
Kiyohiko Dohi
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Lavage ◽  
Surgical Techniques ◽  
Therapeutic Strategies ◽  
Number Of Patients ◽  
Negative Comments ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Timely Administration ◽  
Surgical Option

Encapsulating peritoneal sclerosis (EPS) is an intestinal obstruction syndrome in which peritoneal deterioration and intraperitoneal inflammation result in intestinal adhesions, which are covered with a fibrin capsule and cause bowel obstruction. The widespread use of peritoneal dialysis (PD) has been associated with an increase in the number of patients with this life-threatening complication. For this reason, some negative comments have been made about PD therapy. However, recent clinical studies have elucidated the pathogenesis of EPS and proposed therapeutic strategies. Currently, these facts are known: • EPS occurs in 2.5% of all patients (3.18/1000 patient-years). • A longer duration of PD is associated with a higher incidence of EPS and a poorer prognosis, indicating the involvement of peritoneal deterioration in the development of EPS. • Development of EPS involves some kind of infection. • Development of EPS frequently occurs after PD withdrawal and catheter removal. • Peritoneal lavage after PD withdrawal delays, but cannot prevent the development of EPS. • Timely administration of steroids is effective. • Surgical adhesiolysis is the optimal treatment to relieve bowel obstructions, but does not exclude the potential for re-adhesions, requiring various ingenious gastrointestinal surgical techniques.

scholarly journals Fatal Spontaneous Tumor Lysis Syndrome in a Patient with Metastatic Colon Cancer: A Clinical Case of Rare Oncological Emergency

2020 ◽  
Vol 14 (2) ◽  
pp. 255-260
Author(s):  
Inna Shaforostova ◽  
Robert Fiedler ◽  
Martina Zander ◽  
Johannes Pflumm ◽  
Wolfgang Josef März
Keyword(s):  
Colon Cancer ◽  
Case Reports ◽  
Multiorgan Failure ◽  
Tumor Lysis Syndrome ◽  
Metastatic Colon Cancer ◽  
Tumor Lysis ◽  
Oncological Emergency ◽  
Electrolyte Disturbances ◽  
Life Threatening ◽  
Spontaneous Tumor Lysis Syndrome

Tumor lysis syndrome (TLS) is a potentially life-threatening complication of chemotherapy. It usually occurs in rapidly proliferating hematological malignancies. TLS is deemed spontaneous (STLS) when it occurs prior to any cytotoxic or definite treatment. STLS is extremely rare in solid tumors. Here, we report a rare case of fatal STLS in a 47-year-old woman diagnosed with metastatic colon cancer. The patient developed acute renal failure with anuria, electrolyte disturbances, and metabolic acidosis before initiating chemotherapy. Despite appropriate management of TLS, including renal replacement therapy, she died within a few days from multiorgan failure. Only few other case reports of STLS associated with colon cancer have been reported in the literature.

scholarly journals Hyperleucocytosis in children with acute mieloid leukemia

2020 ◽  
Vol 19 (1) ◽  
pp. 116-121
Author(s):  
N. V. Zacharov ◽  
I. I. Kalinina ◽  
D. A. Venev ◽  
T. Y. Salimova ◽  
D. A. Evseev ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tumor Lysis Syndrome ◽  
Blood Transfusions ◽  
Review Of The Literature ◽  
Specific Therapy ◽  
Important Place ◽  
Tumor Lysis ◽  
Life Threatening

This article presents analysis of recent publications on hyperleukocytosis in children with AML. The mechanisms of the development of life-threatening complications accompanying hyperleukocytosis are analyzed in detail. In this review of the literature, the authors focus on the adequacy and timing of therapy for such life-threatening complications of hyperleukocytosis as leukostasis, DIC, and acute tumor lysis syndrome. The authors emphasize that in the treatment of hyperleukocytosis an important place, in addition to specific therapy, is taken by the accompanying therapy in the intensive care unit. The place of replacement blood transfusions and leukopheresis as part of the accompanying therapy is discussed.

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