Öz
Objective: Tumor lysis
syndrome (TLS) is a clinical picture that occurs with the rapid destruction of
tumor cells and with life-threatening metabolic disorders. The aim of our study
is to evaluate the etiologic causes, diagnosis and treatment of TLS cases.
Method: The study was
conducted between January 2015 and December 2017 in Kahramanmaras
Necip Fazıl city Hospital.
[HT1] A
total of 32 patients diagnosed with TLS were included in the study. Laboratory
values of patients were scanned (blood urea nitrogen, creatinine, potassium,
phosphorus, calcium, serum uric acid, lactate dehydrogenase) and diagnoses,
chemotherapy and treatments were noted.
Results: Of the 32 patients
who were included in the study, 17 were male and 15 were female. The average
age of the patients was found as 62,06 ± 12,10 (35-86) years. Hematologic
malignancy was detected in the etiology of
11 of the TLS cases and solid tumor was detected in 21 of the TLS cases. A
total of 12 (37.5%) patients had spontaneous TLS (5 in haematological
malignancy and 7 in solid tumor). Hyperpotassaemia 50%, hypocalcaemia 46.9%,
hyperphosphatemia, hyperuricemia and acute kidney damage was present in all
patients. Mortality rate was found as 40.6%.
Conclusions: In
our study, spontaneous TLS was detected at a high rate. In addition, the
mortality rate was also high. Early diagnosis and urgent treatment should be
planned to avoid mortalities.
Anahtar Kelimeler
Tumor lysis syndrome malignancy hyperuricemia acute renal damage
Kaynakça
- 1. Cairo MS, Bishop M. Tumour lysis syndrome: new therapeutic strategies and classification. Br J Haematol 2004; 127: 3-11.
- 2. Annemans L, Moeremans K, Lamotte M, Garcia Conde J, van den Berg H, Myint H, et al. Incidence, medical resource utilisation and costs of hyperuricemia and tumour lysis syndrome in patients with acute leukaemia and non-Hodgkin's lymphoma in four European countries. Leukemia& lymphoma 2003;44:77-83.
- 3. Darmon M, Vincent F, Camous L, Canet E, Bonmati C, Braun T, et al. Groupe de Rechercheen Réanimation Respiratoire et Onco-Hématologique (GRRR-OH). Tumour lysis syndrome and acute kidney injury in high-risk haematology patients in the rasburicase era. A prospective multicentre study from the Groupe de Rechercheen Réanimation Respiratoire et Onco-Hématologique. Br J Haematol. 2013;162:489-97.
- 4. Montesinos P, Lorenzo I, Martín G, Sanz J, Pérez-Sirvent ML, Martínez D, et al. Tumor lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model. Haematologica. 2008;93:67-74.
- 5. Mott FE, Esana A, Chakmakjian C, Herrington JD. Tumor lysis syndrome in solid tumors. Support Cancer Ther 2005;2:188–91.
- 6. Vodopivec DM, Rubio JE, Fornoni A, Lenz O. An unusual presentation of tumor lysis syndrome in patient with advanced gastricadenocarcinoma: case report and literature review. Case Rep Med 2012;2012:468452.
- 7. Goyal H, Sawhney H, Bekara S, Singla U. Spontaneous acute tumour lysis syndrome in gastric adenocarcinoma: a case report and literature review.J Gastrointest Cancer 2014;45:208-11.
- 8. Weerasinghe C, Zaarour M, Arnaout S, Garcia G, Dhar M. Spontaneous Tumor Lysis Syndrome in Small-Cell Lung Cancer: A Rare Complication. World J Oncol 2015;6:464-71.
- 9. Sommerhalder D, Takalkar AM, Shackelford R, Peddi P. Spontaneous tumor lysis syndrome in colon cancer: a case report and literature review. Clin Case Rep 2017;5:2121-6.
- 10. Harada S, Nagaharu K, Baba Y, Murata T, Mizuno T, Kawakami K. Spontaneous Tumor Lysis Syndrome in a Patient with a Dedifferentiated Endometrial Adenocarcinoma. Case Rep Oncol Med 2017;2017:5103145.
- 11. Singh A, Gupta S, Yim B, Thekkekara R. Tumor Lysis Syndrome in Multiple Myeloma: An Increasingly Recognized Risk-A Report of Seven Cases. Indian J Hematol Blood Transfus 2017;33:41-4.
- 12. Sezer O, Vesole DH, Singhal S, Richardson P, Stadtmauer E, Jakob C, et al. Bortezomib-induced tumor lysis syndrome in multiple myeloma. Clin Lymphoma Myeloma 2006;7:233-5.
- 13. Firwana BM, Hasan R, Hasan N, Alahdab F, Alnahhas I, Hasan S, et al. Tumor lysis syndrome: a systematic review of case series and case reports.Postgrad. 2012 ;124:92-101.
- 14. Caravaca-Fontán F, Martínez-Sáez O, Pampa-Saico S, Olmedo ME, Gomis A, Garrido P. Tumor lysis syndrome in solid tumors: Clinical characteristics and prognosis. Med Clin (Barc) 2017;148:121-4.
- 15. Darmon M, Guichard I, Vincent F, Schlemmer B, Azoulay E. Prognostic significance of acute renal injury in acute tumor lysis syndrome. Leuk Lymphoma 2010;51: 221–7.
- 16. Darmon M, Vincent F, Canet E, Mokart D, Pène F, Kouatchet A, et al. Acute kidney injury in critically ill patients with haematological malignancies: results of a multicentre cohort study from the Groupe de Rechercheen Réanimation Respiratoireen Onco-Hématologie. Nephrol Dial Transplant. 2015;30:2006-13.
- 17. Tosi P, Barosi G, Lazzaro C, Liso V, Marchetti M, Morra E, et al. Consensus conference on the management of tumor lysis syndrome. Haematologica 2008;93:1877–85.
- 18. Goldman SC. Rasburicase: potential role in managing tumour lysis in patients with hematological malignancies. Expert Rev Anticancer Ther 2003;3:429-33.
Öz
Amaç: Tümör lizis sendromu (TLS), tümör
hücrelerinin hızlı bir şekilde yıkılmasıyla ortaya çıkan ve yaşamı tehdit
edebilen metabolik bozukluklarla seyreden klinik bir tablodur.
Çalışmamızdaki amaç TLS olguların etyolojik nedenleri, tanı ve tedavilerini değerlendirmektir.
Yöntem: Çalışma Ocak 2015 ile Aralık 2017
tarihleri arasında Kahramanmaras Necip Fazıl Şehir [HT1] hastanesinde
yapıldı. Çalışmaya, TLS tanısı konan toplam 32 hasta alındı. Hastaların
dosyaları taranarak laboratuvar değerleri (kan üre azotu, kreatinin, potasyum,
fosfor, kalsiyum, serum ürik asit, laktat dehidrogenaz), tanıları, aldıkları
kemoterapi ve tedavileri not edildi.
Bulgular: Çalışmaya alınan toplam 32 hastanın
17’si erkek, 15’i bayandı. Hastaların ortalama yaşları 62,06±12,10 (35-86) olarak
saptandı. TLS olgularının 11’nin etiyolojisinde hematolojik malignensi, 21’inde
ise solid tümör saptandı. Toplam 12 (37,5%) hastada spontan TLS (5’i
hematolojik malignensi ve 7’si solid tümör) tespit edildi. Hiperpotasemi 50%
oranında, hipokalsemi 46,9% oranında, hiperfosfatemi, hiperürisemi ve akut
böbrek hasarı ise hastaların tümünde mevcuttu. Mortalite oranı 40,6% olarak
saptandı.
Sonuç: Çalışmamızda spontan TLS yüksek oranda
saptandı. Ayrıca mortalite oranıda yüksekti. Mortaliteden kaçınmak için erken
tanı ve acil tedavi planlanmalıdır.
Anahtar Kelimeler
Tümör lizis sendromu malignensi hiperürisemi akut böbrek hasarı
Kaynakça
- 1. Cairo MS, Bishop M. Tumour lysis syndrome: new therapeutic strategies and classification. Br J Haematol 2004; 127: 3-11.
- 2. Annemans L, Moeremans K, Lamotte M, Garcia Conde J, van den Berg H, Myint H, et al. Incidence, medical resource utilisation and costs of hyperuricemia and tumour lysis syndrome in patients with acute leukaemia and non-Hodgkin's lymphoma in four European countries. Leukemia& lymphoma 2003;44:77-83.
- 3. Darmon M, Vincent F, Camous L, Canet E, Bonmati C, Braun T, et al. Groupe de Rechercheen Réanimation Respiratoire et Onco-Hématologique (GRRR-OH). Tumour lysis syndrome and acute kidney injury in high-risk haematology patients in the rasburicase era. A prospective multicentre study from the Groupe de Rechercheen Réanimation Respiratoire et Onco-Hématologique. Br J Haematol. 2013;162:489-97.
- 4. Montesinos P, Lorenzo I, Martín G, Sanz J, Pérez-Sirvent ML, Martínez D, et al. Tumor lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model. Haematologica. 2008;93:67-74.
- 5. Mott FE, Esana A, Chakmakjian C, Herrington JD. Tumor lysis syndrome in solid tumors. Support Cancer Ther 2005;2:188–91.
- 6. Vodopivec DM, Rubio JE, Fornoni A, Lenz O. An unusual presentation of tumor lysis syndrome in patient with advanced gastricadenocarcinoma: case report and literature review. Case Rep Med 2012;2012:468452.
- 7. Goyal H, Sawhney H, Bekara S, Singla U. Spontaneous acute tumour lysis syndrome in gastric adenocarcinoma: a case report and literature review.J Gastrointest Cancer 2014;45:208-11.
- 8. Weerasinghe C, Zaarour M, Arnaout S, Garcia G, Dhar M. Spontaneous Tumor Lysis Syndrome in Small-Cell Lung Cancer: A Rare Complication. World J Oncol 2015;6:464-71.
- 9. Sommerhalder D, Takalkar AM, Shackelford R, Peddi P. Spontaneous tumor lysis syndrome in colon cancer: a case report and literature review. Clin Case Rep 2017;5:2121-6.
- 10. Harada S, Nagaharu K, Baba Y, Murata T, Mizuno T, Kawakami K. Spontaneous Tumor Lysis Syndrome in a Patient with a Dedifferentiated Endometrial Adenocarcinoma. Case Rep Oncol Med 2017;2017:5103145.
- 11. Singh A, Gupta S, Yim B, Thekkekara R. Tumor Lysis Syndrome in Multiple Myeloma: An Increasingly Recognized Risk-A Report of Seven Cases. Indian J Hematol Blood Transfus 2017;33:41-4.
- 12. Sezer O, Vesole DH, Singhal S, Richardson P, Stadtmauer E, Jakob C, et al. Bortezomib-induced tumor lysis syndrome in multiple myeloma. Clin Lymphoma Myeloma 2006;7:233-5.
- 13. Firwana BM, Hasan R, Hasan N, Alahdab F, Alnahhas I, Hasan S, et al. Tumor lysis syndrome: a systematic review of case series and case reports.Postgrad. 2012 ;124:92-101.
- 14. Caravaca-Fontán F, Martínez-Sáez O, Pampa-Saico S, Olmedo ME, Gomis A, Garrido P. Tumor lysis syndrome in solid tumors: Clinical characteristics and prognosis. Med Clin (Barc) 2017;148:121-4.
- 15. Darmon M, Guichard I, Vincent F, Schlemmer B, Azoulay E. Prognostic significance of acute renal injury in acute tumor lysis syndrome. Leuk Lymphoma 2010;51: 221–7.
- 16. Darmon M, Vincent F, Canet E, Mokart D, Pène F, Kouatchet A, et al. Acute kidney injury in critically ill patients with haematological malignancies: results of a multicentre cohort study from the Groupe de Rechercheen Réanimation Respiratoireen Onco-Hématologie. Nephrol Dial Transplant. 2015;30:2006-13.
- 17. Tosi P, Barosi G, Lazzaro C, Liso V, Marchetti M, Morra E, et al. Consensus conference on the management of tumor lysis syndrome. Haematologica 2008;93:1877–85.
- 18. Goldman SC. Rasburicase: potential role in managing tumour lysis in patients with hematological malignancies. Expert Rev Anticancer Ther 2003;3:429-33.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Dahili Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Mart 2019 |
| Kabul Tarihi | 20 Mart 2019 |
| Yayımlandığı Sayı | Yıl 2019 |