1/52. Spurious elevation of automated platelet counts in secondary acute monocytic leukemia associated with tumor lysis syndrome.The intent of this article is to describe the effect of tumor lysis on automated platelet counts in therapy-related, secondary acute monocytic leukemia. The first patient was a 69-year-old man with large cell carcinoma of the lung who developed acute monocytic leukemia 1(1/2) years after initiation of radiation and chemotherapy for his carcinoma. The second patient was a 72-year-old female with peripheral T-cell lymphoma who developed acute monocytic leukemia 1 year after initiation of chemotherapy for her lymphoma. Platelet counts were determined by the automated Coulter (STKS) counter. Both patients had clinical and laboratory evidences of tumor lysis syndrome and disseminated intravascular coagulation. The peripheral blood smears revealed numerous fragments of leukemic cells and apoptotic cells with pyknotic nuclei. The Coulter machine enumerated these cellular fragments as platelets, resulting in falsely elevated platelet counts. awareness of this laboratory artifact in secondary acute monocytic leukemia with tumor lysis syndrome is important so that potential life-threatening thrombocytopenia is not overlooked.- - - - - - - - - - ranking = 1keywords = lymphoma (Clic here for more details about this article) |
2/52. Hepatic tumor rupture following effectual treatment with irinotecan in a patient with highly refractory malignant lymphoma.We describe a patient with highly refractory malignant lymphoma who died of hepatic tumor rupture following treatment with irinotecan (CPT-11). This 60-year-old man with non-Hodgkin's lymphoma (diffuse large B-cell lymphoma) demonstrated disease recurrence in the liver and the vertebrae following high-dose chemotherapy and autologous hematopoietic stem cell transfusion. He was treated with CPT-11 at a dose of one third of the conventional dose used for non-Hodgkin's lymphoma in japan. The tumor in the liver markedly decreased in size but then ruptured. Although pathologic hepatic tumor rupture is a rare complication in patients with malignant lymphoma of the liver, this case demonstrates that hepatic tumor rupture may occur in refractory malignant lymphomas that reveal extensive degradation by this new, effective salvage therapy.- - - - - - - - - - ranking = 5keywords = lymphoma (Clic here for more details about this article) |
3/52. tumor lysis syndrome occurring after the administration of rituximab in lymphoproliferative disorders: high-grade non-Hodgkin's lymphoma and chronic lymphocytic leukemia.Rituximab, an anti-CD20 antibody, has been recently approved for the treatment of low-grade or follicular non-Hodgkin's lymphoma (NHL). Because of its relatively benign side effect profile, it has been considered a nontoxic alternative to chemotherapy. Recently, however, tumor lysis syndrome (TLS) resulting from rituximab has been reported in a patient with chronic lymphocytic leukemia (CLL). We herein present two cases of rituximab-induced TLS. The first case occurred in a patient with high-grade NHL, while the second case occurred in a patient with CLL. We also present a summary of the literature regarding TLS induced by immunotherapies.- - - - - - - - - - ranking = 2.5keywords = lymphoma (Clic here for more details about this article) |
4/52. Asystole during combination chemotherapy for non-Hodgkin's lymphoma: the acute tumor lysis syndrome.The acute tumor lysis syndrome is a rare condition that has most frequently been documented in patients with rapidly dividing myeloproliferative and lymphoproliferative malignancies. It is characterized by the development of hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, acute renal failure and metabolic acidosis, as a result of massive tumor cell destruction, usually secondary to effective cytotoxic treatment. We want to present the case history of a 62-year-old woman who died from cardiorespiratory arrest during combination chemotherapy for non-Hodgkin's lymphoma due to acute tumor lysis syndrome. Despite general preventive measures, severe electrolyte abnormalities developed within 18 h of the start of chemotherapy. The general guidelines for the management of this potentially fatal oncologic emergency are discussed, with special emphasis on the pathogenetic mechanisms and risk factors in our patient.- - - - - - - - - - ranking = 2.5keywords = lymphoma (Clic here for more details about this article) |
5/52. Continuous veno-venous hemodiafiltration for the treatment of spontaneous tumor lysis syndrome complicated by acute renal failure and severe hyperuricemia.We describe a case of Burkitt's lymphoma presenting as spontaneous tumor lysis syndrome (TLS) complicated by severe hyperuricemia and anuric acute renal failure presumed to be secondary to uric acid nephropathy. The patient was treated with continuous veno-venous hemodiafiltration (CVVHDF) using a dialysate flow rate of 2.5 l/h, and a replacement fluid rate of 1.5 l/h (administered in pre-dilution). Mean clearances during CVVHDF for urea, creatinine, uric acid, and phosphorus were, respectively, 55.8 /- 3.8, 48.9 /- 2.6, 45.1 /- 2.6 and 47.0 /- 3.3 ml/min (or 80, 70, 65 and 68 l/day, respectively). serum urea, creatinine, uric acid, and phosphorus decreased from 42 to 9 mmol/l, 533 to 189 micromol/l, 1980 to 372 micromol/l, and 2.0 to 1.4 mmol/l, respectively, after 48 hours of CVVHDF. Previously, we reported the use of continuous arteriovenous hemodialysis (CAVHD) at a high dialysate flow rate of 4 l/h for the treatment of acute renal failure and TLS, which provided excellent continuous clearances of small molecular weight solutes. This last modality was very efficient and prevented deleterious rebound in serum solute concentrations frequently observed in TLS after intermittent hemodialysis (IHD). It was concluded that high-dialysate flow rate CAVHD was a more potent form of treatment than conventional IHD. With recent advances in technology, veno-venous continuous renal replacement therapies are becoming more popular than arterio-venous modalities since they are safer and less cumbersome. Furthermore, flow rates being precisely regulated, solute clearances can be steadily maintained. With CVVHDF flow rates as used in this report, we achieved excellent solute clearances and metabolic control. We propose CVVHDF as an ideal treatment for acute renal failure in TLS. In our opinion, CVVHDF is an advantageous alternative to treat TLS complicated by acute renal failure.- - - - - - - - - - ranking = 0.5keywords = lymphoma (Clic here for more details about this article) |
6/52. tumor lysis syndrome following hemi-body irradiation for metastatic breast cancer.tumor lysis syndrome (TLS) is a rare serious acute complication of cancer therapy, reported mainly following chemotherapy in patients with large tumor load and chemosensitive disease. These are mainly patients with non-Hodgkin's lymphoma, leukemia and rarely in solid tumors. It is less frequently described after radiotherapy for lymphoid and hematological malignancies. TLS following radiotherapy for solid tumors is a very rare complication. In this report/review we describe a seventy-three-year-old male patient with progressive metastatic carcinoma of the breast to the lungs, liver and bone. He was referred for radiotherapy because of generalized bony pains. The patient was planned for sequential hemi-body irradiation starting with the more symptomatic upper half body. After premedication, he was given 8.5 Gy to the mid point at the maximum chest separation with anterior lung attenuator limiting uncorrected lung dose to 6.15 Gy. A further 3.5 Gy electron boost to the fungating breast tumor was given to the 100%. Forty-eight hours after irradiation he developed hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia and renal failure. These clinical and biochemical changes are typical of tumor lysis syndrome (TLS). Despite hydration, and treating the hyperuricemia, the patient developed coma and died eight days after irradiation. The prophylaxis and management of TLS and in high-risk patients are described to avoid this frequently fatal complication.- - - - - - - - - - ranking = 0.5keywords = lymphoma (Clic here for more details about this article) |
7/52. Spontaneous acute tumor lysis syndrome with advanced gastric cancer.Acute tumor lysis syndrome (TLS) occurs frequently in hematologic malignancies such as high-grade lymphomas and acute leukemia, which are rapidly proliferating and chemosensitive tumors. It occurs rarely in solid tumors and has never been reported in gastric adenocarcinoma. Typical biochemical findings of acute tumor lysis syndrome are hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia in patients with a malignancy. Rapid changes of these electrolytes may cause cardiac arrhythmia, seizure, acute renal failure and sudden death. Therefore, as soon as it is detected, it should be taken care of immediately. Until now almost all cases of TLS associated with solid tumor have developed after cytoreductive therapy in chemosensitive tumors. We report here a case of spontaneous acute tumor lysis in a patient of advanced gastric cancer with hepatic metastases and multiple lymphadenopathy. The biochemical finding of TLS improved with the management and tumor burden also showed slight response to the one cycled combination chemotherapy but the patient died of progressive pneumonia.- - - - - - - - - - ranking = 0.5keywords = lymphoma (Clic here for more details about this article) |
8/52. Acute spontaneous tumor-lysis syndrome in a pregnant woman with non-Hodgkin's lymphoma.Both non-Hodgkin's lymphoma (NHL) in pregnancy and acute spontaneous tumor-lysis (ASTL) syndrome are rare. Here we present a 32-year-old Egyptian woman in the 27th week of pregnancy, who was admitted with epistaxis, lethargy, vomiting and dehydration. This patient developed ASTL syndrome secondary to undiagnosed NHL, but was not on any medication associated with the syndrome. At 28 weeks, she gave birth to a healthy baby who, unfortunately, died within a few days. To our knowledge, this is the first case of ASTL syndrome in a pregnant woman.- - - - - - - - - - ranking = 2.5keywords = lymphoma (Clic here for more details about this article) |
9/52. Acute tumor lysis syndrome induced by high-dose corticosteroids in a patient with chronic lymphatic leukemia.Acute tumor lysis syndrome (TLS) has been reported in hematological malignancies, such as aggressive non-Hodgkin's lymphoma, acute lymphoblastic leukemia, and rarely, in other malignancies (solid tumors) in association with the administration of cytotoxic therapy. We report a case of a patient with chronic lymphatic leukemia (CLL) who developed autoimmune hemolytic anemia treated by high dose corticosteroids and, following this treatment, developed acute tumor lysis syndrome. Only one similar case has been reported recently. Clinicians should be aware that corticosteroids alone may produce this potentially life-threatening complication.- - - - - - - - - - ranking = 0.5keywords = lymphoma (Clic here for more details about this article) |
10/52. Acute tumour lysis syndrome following a single-dose corticosteroid in children with acute lymphoblastic leukaemia.Acute tumour lysis syndrome (ATLS) is a well recognised complication of treatment of a variety of malignant disorders. It commonly occurs in patients with non-Hodgkin's lymphoma (NHL) and acute lymphoblastic leukaemia (ALL) with the administration of combined cytotoxic chemotherapy. It is rarely reported after single-agent corticosteroid therapy. We present two children with acute lymphoblastic leukaemia of T-cell lineage who developed acute tumour lysis syndrome after a single dose of prednisolone, and methylprednisolone at the beginning of the induction chemotherapy. In the first case (an 11-yr-old) ATLS had occurred after an oral dose of prednisolone as small as 12 mg and within 18 h. The second case was a 14-yr-old boy with ALL who developed ATLS following a single dose of methylprednisolone. A few similar cases in the English literature are summarised in the report. These cases indicate that acute tumour lysis syndrome may occur after a single dose of corticosteroids. One should be aware of this potentially life-threatening complication especially while prescribing corticosteroids to patients with NHL and leukaemia.- - - - - - - - - - ranking = 0.5keywords = lymphoma (Clic here for more details about this article) |
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