Clinical Case Database / Category: Patient Management
Recognition and management of tumour lysis syndrome
Publication details
Jennifer A Bradbury MBBCh, MRCP, Judith Cave MD
Foundation Years Journal, volume 4, issue 4, p.17 (123Doc Education, London, April 2010)
Abstract
Tumour lysis syndrome is a potential complication of chemotherapy, and occurs due to extensive cellular breakdown in patients with bulky, rapidly proliferating and highly treatment-sensitive tumours1. It results in the release of intracellular contents into the circulation, and may lead to metabolic disturbance, renal failure and cardiac arrhythmias. This article will focus on the case of a patient who developed tumour lysis syndrome during treatment for Burkitt's lymphoma. It will aim to highlight the identification of high-risk patients, strategies for prevention, and treatment of the metabolic and renal complications.
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Authors
Jennifer A Bradbury MBBCh, MRCP
Specialist Registrar in Medical Oncology Southampton University Hospitals Trust
Judith Cave MD
Consultant Medical Oncologist Southampton University Hospitals Trust
References
1. Jagasia MH, Arrowsmith ER. (2003) Complications of haematopoietic neoplasms. In Wintrobe MM, Greer JP, Foerster J, et al. Wintrobe's Clinical Haematology. Vol II, 11th ed. Philadelphia: Lippincott, Williams & Wilkins, 1919-1944.
2. Cairo MS, Bishop M. (2004)Tumour lysis syndrome: new therapeutic strategies and classification. British Journal of Haematology, 127:3-11.
3. Krishnan K, Hammad A. Tumour lysis syndrome. http://emedicine.medscape.com/article/282171
4. Hochberg J, Cairo MS. (2008) Tumour lysis syndrome: current perspective. Haematologica, 93: 9-13.
5. Tosi P, Barosi G, Lazzaro C, et al. (2008) Consensus conference on the management of tumour lysis syndrome. Haematologica, 93: 1877-1885.
6. Goldman SC, Holcenberg JS, Finklestein JZ. (2001) A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukaemia at high risk for tumour lysis. Blood, 97:2998-3003.
7. Van den Berg H, Reintsema AM. (2004) Renal tubular damage in rasburicase: risks of alkalinisation. Annals of Oncology, 15:175-6.
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About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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