Tumor lysis syndrome complicating treatment of chronic lymphocytic leukemia with fludarabine phosphate
Article Abstract:
Tumor lysis syndrome (TLS) is a complication that follows effective cancer chemotherapy and is caused by rapid destruction (lysis) of a large volume of cancerous cells. TLS is characterized by high blood levels of phosphate, potassium, uric acid, and uric acid-associated kidney dysfunction. It usually accompanies high-grade lymphoma or acute leukemia, but rarely occurs with chronic leukemia, presumably due to its slow progression. Fludarabine is an effective treatment of chronic lymphocytic leukemia (CLL), and a case is reported of a 66-year-old man with (CLL) treated with fludarabine who subsequently developed TLS. Previous chemotherapy had failed. The patient developed TLS following four days of treatment with fludarabine. The patient had upper abdominal pain, along with a reduction in CLL-associated spleen and lymph node enlargement. Kidney parameters were also reduced, and urine contained blood cells and uric acid crystals. Treatment with painkillers, fluids, and allopurinol, an inhibitor of uric acid synthesis, was administered. The patient returned to normal within six days, allopurinol and forced fluids was given with subsequent fludarabine treatments. This is the third reported case of TLS associated with fludarabine treatment of CLL. The overall incidence is unknown, but preventive measures should be considered for patients at risk for TLS. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Acute tumor lysis syndrome in prolymphocytic leukemia
Article Abstract:
Acute tumor lysis syndrome (TLS) is the sudden deterioration of a large, rapidly growing tumor, and may occur after treatment with anticancer agents. TLS has been reported after chemotherapeutic treatment of Burkitt's lymphoma, a cancer of the lymphatic system, and prolymphocytic leukemia, a blood cancer associated with abnormal B cells, a type of immune cell. A case is described of a 70-year-old man who developed TLS after treatment of prolymphocytic leukemia with dexamethasone. Prolymphocytic leukemia is a slow-growing B cell cancer associated with the development of large tumors, and does not usually have a rapid response to anticancer treatment. This case was unusual in that it involved rapid tumor progression and impressive therapeutic responses. Although steroids are known to be active against other cancers involving the overgrowth of lymphocyte cells, this is the first report of dexamethasone alone effectively treating prolymphocytic leukemia. The biochemical changes associated with dexamethasone therapy are consistent with acute TLS, and dexamethasone alone should be used with caution in treating prolymphocytic leukemia. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Successful use of granulocyte-macrophage colony-stimulating factor in patients with acute lymphocytic leukemia
Article Abstract:
Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a human protein which stimulates the production of certain white blood cells and can be produced in the laboratory through biotechnology. GM-CSF has been used to successfully treat neutropenia, low levels of neutrophils (white blood cells), a common side effect of cancer chemotherapy, and other disorders related to leukemia and AIDS. Successful treatment of two patients with acute lymphocytic leukemia (ALL) using GM-CSF is described. Both patients developed very low levels of neutrophils after chemotherapy, and consequently developed moderate-to-severe medical difficulties. Treatment with GM-CSF increased neutrophil levels to normal, and medical problems associated with neutropenia resolved. No stimulation of ALL cells was observed with the treatment. One patient remains in remission. The study suggests that treatment with GM-CSF may allow patients to tolerate higher, more effective doses of chemotherapy. Until further study of the safety and effects of GM-CSF can be performed, treatment should be considered on a case by case basis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
User Contributions:
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