Cases reported "Tumor Lysis Syndrome"

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1/12. Acute spontaneous tumor lysis syndrome in adenocarcinoma of the lung: a case report.

    Acute tumor lysis syndrome (ATLS) is a constellation of metabolic complications that typically occurs in the setting of treatment of hematologic malignancies. On occasion, it has been reported to occur after therapy for solid tumors associated with large tumor burdens and aggressive therapy. We herein report the occurrence of spontaneous acute tumor lysis syndrome in a man with untreated metastatic adenocarcinoma of the lung, and briefly discuss the literature.
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2/12. 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.
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3/12. tumor lysis syndrome in extensive-stage small-cell lung cancer.

    tumor lysis syndrome is a constellation of metabolic complications that occurs in the setting of treatment of hematologic malignancies. On occasion, it has been reported to occur after therapy for solid tumors associated with large tumor burdens and aggressive therapy. We herein report the rare occurrence of acute tumor lysis syndrome in a woman with extensive-stage small-cell lung cancer after cytotoxic therapy.
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4/12. Peracute onset of severe tumor lysis syndrome immediately after 4 Gy fractionated TBI as part of reduced intensity preparative regimen in a patient with T-ALL with high tumor burden.

    We report a 30-year-old patient with therapy-refractory T-ALL undergoing unrelated allogeneic PBSCT. He developed severe tumor lysis syndrome (TLS) with extreme biochemical changes, cardiac and neurological symptoms and dialysis-dependent acute renal failure after TBI (4 Gy) on the first day of reduced intensity conditioning (RIC) for unrelated allogeneic PBSCT. The patient's clinical condition was stabilized after beginning daily hemodialysis and treatment for disturbed electrolytes, metabolic acidosis and plasma coagulation, as well as reduction of uric acid by rasburicase. The conditioning therapy and the allogenic PBSCT were scheduled according to the preparative regimen. According to our knowledge, severe TLS induced by 4 Gy TBI has not been reported so far. Regimen-related toxicity using RIC regimen was mild, allowing 30-50% of the patients to have an entirely outpatient transplantation. However, we would like to point out that severe TLS could also complicate PBSCT using RIC regimens in patients with relatively radiation-sensitive malignancies and high tumor burden.
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5/12. Multicentric Castleman's disease complicated by tumor lysis syndrome.

    We report a case of Castleman's disease that developed tumor lysis syndrome spontaneously and after systemic chemotherapy. A 44-year-old male patient was admitted with a 2-week history of abdominal distension accompanied by dyspnea. physical examination revealed multiple lymph node enlargements. After admission, spontaneous hemoperitoneum developed and he underwent exploratory laparotomy, with the removal of the ruptured spleen. Pathologic review of the splenic tissue and excised lymph node gave the diagnosis of multicentric Castleman's disease. He experienced two episodes of tumor lysis syndrome, initially spontaneous and then chemotherapy related, which needed vigorous management including hemodialysis and intensive fluid therapies. To our knowledge, this is the first reported case of Castleman's disease complicated by tumor lysis syndrome. This suggests that the possibility of tumor lysis syndrome should be considered when treating Castleman's disease with a large disease burden.
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6/12. Tumour lysis syndrome in multiple myeloma after bortezomib (VELCADE) administration.

    Bortezomib (VELCADE) is a proteasome inhibitor, which has been recently used for the treatment of relapsed/refractory multiple myeloma (MM) with encouraging results. Tumour lysis syndrome (TLS) has been described during chemotherapy for many haematological malignancies, such as acute lymphoblastic leukaemia and high-grade lymphomas. TLS is very rare in MM with ten reported cases, including approximately 1% of patients receiving high-dose chemotherapy with stem cell support (ASCT). We report here a patient with refractory MM and deletion 13q, who had received more than four lines of previous treatment, including two ASCT, and had relapsed. The patient received bortezomib, as a single agent, at a dose of 1.3 mg/m(2) twice per week for 2 weeks, in a 3-week cycle, and developed TLS after the second dose of cycle one. Bortezomib therapy, due to the rapidity of its action, may result in TLS in myeloma patients who have rapidly proliferative disease with a high tumour burden. Therefore, TLS should be looked for during the first cycle of bortezomib treatment and suitable precautions should be considered.
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7/12. tumor lysis syndrome after bortezomib therapy for plasma cell leukemia.

    tumor lysis syndrome (TLS) is a manifestation of metabolic disturbances that can lead to severe treatment complications and ultimately life-threatening events. This syndrome has been reported in solid tumors but is more common in bulky, hyperproliferative malignancies. tumor lysis syndrome in plasma cell malignancies is less common due to the low turnover rate of the malignant B cells. Bortezomib is the first proteasome inhibitor approved by the united states food and drug administration as second- and third-line therapy for patients with relapsed multiple myeloma. We describe the case of a patient with plasma cell leukemia treated with bortezomib who developed TLS. Bortezomib was begun as single-agent therapy that resulted in the development of TLS after the third dose of the first cycle. Evaluation with the Naranjo Adverse Drug Reaction probability Scale indicated a probable relationship between TLS and bortezomib in this patient. patients receiving bortezomib may be at risk for TLS, especially if they have high tumor burden, rapidly proliferative disease, and unfavorable cytogenetics.
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8/12. tumor lysis syndrome associated with reduced immunosuppression in a lung transplant recipient.

    tumor lysis syndrome usually occurs after Initiation of chemotherapy or radiation therapy in cancer patients with a moderate to high tumor burden. To our knowledge, the occurrence of this syndrome after discontinuation or reduction of an immunosuppressive regimen has not been reported in the literature. We describe a patient who had undergone lung transplantation and who was receiving immunosuppression and experienced an episode of acute pancreatitis. During the course of the work-up, the patient was found to have a B-cell lymphoma (posttransplantation lymphoproliferative disease). His tacrolimus dosage was decreased, and azathioprine was discontinued. The patient subsequently developed tumor lysis syndrome. Other than the decrease in immunosuppression, we found no other factor that could have accounted for this syndrome.
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9/12. Prevention of urate nephropathy in the tumour lysis syndrome.

    patients with acute lymphoblastic leukaemia and a high tumour burden are at risk of developing acute renal failure when given chemotherapy. Rapid cell lysis releases a high urate load which may result in an obstructive urate nephropathy. This complication should be prevented by establishing an alkaline diuresis before initiating steroid or other chemotherapy.
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keywords = tumour burden, burden
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10/12. tumor lysis syndrome in nonhematologic malignancies. Report of a case and review of the literature.

    tumor lysis syndrome (TLS), resulting from massive necrosis of neoplastic cells after chemotherapy, is a rare complication in nonhematologic malignancies. A 32-year-old woman suffering from a rapidly progressing breast adenocarcinoma metastatic to the liver and bones received a course of single-agent chemotherapy with mitoxanthrone and 4 days later developed the tumor lysis syndrome, and subsequently acute renal failure. The patient responded well to appropriate treatment. This case report points out that breast cancer can be extremely sensitive to chemotherapy and suggests that prophylaxis for tumor lysis syndrome should be considered in the subset of patients with breast carcinoma who have hepatic metastases and large tumor burdens.
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