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Attinà G, Tepedino R, Ruggiero A. Acute Tumor Lysis Syndrome: A Metabolic Emergency in Cancer Patients. BIOMEDICAL AND PHARMACOLOGY JOURNAL 2021; 14:1721-1729. [DOI: 10.13005/bpj/2273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Tumor lysis syndrome (TLS) can be a life-threatening complication that occurs following the onset of chemotherapy treatment, most commonly in association with high-grade lymphoproliferative pathologies such as acute lymphoblastic leukemia and Burkitt lymphoma. The massive cell lysis caused by cytotoxic therapy leads to the rapid release in the blood of intracelullary products and the onset of severe metabolic and electrolytic complications (hyperkalemia, hyperphosphatemia, hypocalcemia and hyperuricemia) upto the acute renal failure. This article describes the incidence and pathophysiological basis of TLS, focusing on the new therapeutic strategies implemented over the last few years, especially with regard to the treatment of hyperuricemia. In particular, it highlights the characteristics of a recent drug, Rasburicase, as a safe and effective alternative, compared to traditional allopurinol therapy, for prophylaxis and treatment of children with hyperuricemia induced by chemotherapy.
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Affiliation(s)
- Giorgio Attinà
- 1Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, Rome, Italy
| | | | - Antonio Ruggiero
- 1Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Universita’ Cattolica Sacro Cuore, Rome, Italy
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Abstract
Tumour lysis syndrome (TLS) is a significant complication of haematologic malignancies and their management. The syndrome consists of laboratory abnormalities either alone (laboratory TLS) or with clinical sequelae including renal failure, seizures, and arrhythmias (clinical TLS). Clinical TLS is a predictor for worse overall morbidity and mortality in cancer patients, but can be prevented. Thus, accurate prognostication is critical to appropriate management of patients at risk for TLS, and incorporates both disease factors (tumour type and burden) and patient factors (baseline renal insufficiency or hyperuricaemia). Strategies to prevent TLS include hydration and allopurinol in low- and intermediate-risk patients and rasburicase in high-risk patients.
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Affiliation(s)
- Urshila Durani
- Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - William J Hogan
- Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, MN, USA
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Abstract
Tumor lysis syndrome is a constellation of metabolic derangements seen when tumor cells die and release their intracellular contents into the systemic circulation. Hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia may lead to severe organ dysfunction and even death. Tumor lysis syndrome is classically considered a complication of successful cancer treatment, but it can also occur in untreated malignancies characterized by rapid proliferation. In this review, we cover the types of cancers and chemo- and immunotherapies associated with tumor lysis syndrome, the mechanisms by which severe metabolic derangements can develop, and the available treatments.
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Affiliation(s)
- Krishna Sury
- Section of Nephrology, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
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Abstract
Since its initial description in 1958, Burkitt lymphoma has become a prototype for our understanding of the pathogenesis and optimal treatment of aggressive lymphomas. The evolution of the treatment of this disease is explored and current therapeutic approaches evaluated. Special issues in the treatment of Burkitt lymphoma will also be discussed, including considerations in patients infected with HIV and current views on prophylactic measures and treatment of tumor lysis syndrome.
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Affiliation(s)
- John Gerecitano
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. gerecitj@@mskcc.org
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Sonbol MB, Yadav H, Vaidya R, Rana V, Witzig TE. Methemoglobinemia and hemolysis in a patient with G6PD deficiency treated with rasburicase. Am J Hematol 2013; 88:152-4. [PMID: 22573495 DOI: 10.1002/ajh.23182] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 02/27/2012] [Indexed: 01/12/2023]
Affiliation(s)
| | - Hemang Yadav
- Division of Internal Medicine; Mayo Clinic; Rochester; Minnesota
| | - Rakhee Vaidya
- Division of Hematology; Mayo Clinic; Rochester; Minnesota
| | - Vishal Rana
- Division of Hematology; Mayo Clinic; Rochester; Minnesota
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Dargart JL, Hijiya N. Metabolic Emergencies in the Child With Acute Leukemia. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2011. [DOI: 10.1016/j.cpem.2011.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Spontaneous or treatment-induced tumor lysis syndrome (TLS) can cause significant morbidity and potential mortality. Vigorous hydration, alkalinization and inhibition of uric acid synthesis with allopurinol are the most frequently used methods for treatment and prevention of TLS. However, this approach fails to prevent renal insufficiency in up to 25% of high-risk patients. With the increased intensity and efficacy of cancer therapies, novel approaches for the management of TLS are needed. Unlike allopurinol, urate oxidase promptly reduces the existing uric acid pool, prevents accumulation of xanthine and hypoxanthine and does not require alkalinization, facilitating phosphorus excretion. A recombinant form of urate oxidase, rasburicase, is now registered for the treatment and prevention of TLS. This review provides an overview of rasburicase development and discusses the impact of rasburicase in the prevention and management of TLS.
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Affiliation(s)
- Bertrand Coiffier
- Centre Hospital Lyon-Sud, Department of Hematology, 69310 Pierre-Benite, France.
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9
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Metabolic Emergencies in Oncology. Oncology 2006. [DOI: 10.1007/0-387-31056-8_72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Olgar S, Yetgin S, Cetin M, Aras T, Akhan O. Electrolyte abnormalities at diagnosis of acute lymphocytic leukemia may be a clue for renal damage in long-term period. J Pediatr Hematol Oncol 2005; 27:202-6. [PMID: 15838391 DOI: 10.1097/01.mph.0000161271.68054.b9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The objective of this study was to determine the frequency of electrolyte perturbations and their relationship with leukemic status before and after chemotherapy in patients with acute lymphocytic leukemia. Blood biochemistry, liver and renal function tests, and renal sonograms were examined at diagnosis and during induction therapy in 334 patients. Renal and electrolyte disturbances were then studied in 116 patients between 3 and 110 months after cessation of the St. Jude chemotherapy treatment protocol. Glomerular filtration rate, electrolyte, protein, and beta-2-microglobulin levels were determined in fresh urine samples, and serum electrolyte levels were examined in blood samples. Renal sonographic examinations and scintigraphic examinations were performed with DMSA and MAG-3. Renal leukemic involvement was detected by sonographic examination in 32 patients who had also presented with hyperphosphatemia or hyperuricemia. Patients with electrolyte disorders at diagnosis were less likely to have tumor lysis syndrome during induction chemotherapy. This may be explained by correction of their electrolyte disorders at the time of diagnosis, which may protect them from tumor lysis syndrome. Hypocalcemia and hyponatremia at the time of diagnosis were found to be significant initial risk factors for renal scan abnormalities and microproteinuria, respectively, during the late therapy period (P < 0.05). Electrolyte abnormalities and renal changes were commonly observed before and after therapy for leukemia. Patients presenting with hypocalcemia and hyponatremia should be examined for microproteinuria and should undergo renal scanning during the late therapy period.
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Affiliation(s)
- Seref Olgar
- Department of Pediatric Hematology, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey
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Humphreys BD, Soiffer RJ, Magee CC. Renal Failure Associated with Cancer and Its Treatment: An Update. J Am Soc Nephrol 2004; 16:151-61. [PMID: 15574506 DOI: 10.1681/asn.2004100843] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Benjamin D Humphreys
- Renal Division, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
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Abstract
Tumour lysis syndrome (TLS) describes the metabolic derangements that occur with tumour breakdown following the initiation of cytotoxic therapy. TLS results from the rapid destruction of malignant cells and the abrupt release of intracellular ions, nucleic acids, proteins and their metabolites into the extracellular space. These metabolites can overwhelm the body's normal homeostatic mechanisms and cause hyperuricaemia, hyperkalaemia, hyperphosphaetemia, hypocalcaemia and uraemia. TLS can lead to acute renal failure and can be life-threatening. Early recognition of patients at risk and initiation of therapy for TLS is essential. There is a high incidence of TLS in tumours with high proliferative rates and tumour burden such as acute lymphoblastic leukaemia and Burkitt's lymphoma. The mainstays of TLS prophylaxis and treatment include aggressive hydration and diuresis, control of hyperuricaemia with allopurinol prophylaxis and rasburicase treatment, and vigilant monitoring of electrolyte abnormalities. Urine alkalinization remains controversial. Unfortunately, there have been few comprehensive reviews on this important subject. In this review, we describe the incidence, pathophysiological mechanisms of TLS and risk factors for its development. We summarise recent advances in the management of TLS and provide a new classification system and recommendations for prophylaxis and/or treatment based on this classification scheme.
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Affiliation(s)
- Mitchell S Cairo
- Department of Pediatrics, Children's Hospital of New York Presbyterian, Columbia University, New York, NY 10032, USA.
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Marenco JP, Nervi A, White AC. ARDS associated with tumor lysis syndrome in a patient with non-Hodgkin's lymphoma. Chest 1998; 113:550-2. [PMID: 9498984 DOI: 10.1378/chest.113.2.550] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
ARDS developed in association with tumor lysis syndrome (TLS) in a patient with non-Hodgkin's lymphoma. Although a number of life-threatening complications have been noted to occur following TLS, this appears to be the first report of ARDS developing in association with TLS.
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Affiliation(s)
- J P Marenco
- Department of Internal Medicine, New England Medical Center, Boston, MA 02111, USA
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Larsen G, Loghman-Adham M. Acute renal failure with hyperuricemia as initial presentation of leukemia in children. J Pediatr Hematol Oncol 1996; 18:191-4. [PMID: 8846137 DOI: 10.1097/00043426-199605000-00020] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE We report on two children who presented with hyperuricemia and acute renal failure (admission uric acid levels 57.4 and 59.2 mg/dl). RESULTS Both were subsequently diagnosed to have acute lymphoblastic leukemia, despite normal initial complete blood counts and peripheral smear. Neither patient had nephromegaly on renal ultrasound. CONCLUSIONS Hyperuricemia and acute renal failure, particularly if recurrent, may be an early presentation of childhood leukemia and should lead to a bone marrow aspirate/biopsy.
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Affiliation(s)
- G Larsen
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, USA
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Abstract
PURPOSE To identify patients with lymphoma at risk for tumor lysis after chemotherapy. PATIENTS AND METHODS The case records of 102 patients receiving combination chemotherapy for non-Hodgkin's lymphoma (intermediate to high-grade histology) were reviewed. Patients were considered to have "laboratory tumor lysis" if two of the following metabolic changes occurred within 4 days of treatment: a 25% increase in the serum phosphate, potassium, uric acid, or urea nitrogen concentrations, or a 25% decline in the serum calcium concentration. "Clinical tumor lysis" was defined as laboratory tumor lysis plus one of the following: a serum potassium level greater than 6 mmol/L, a creatinine level greater than 221 mumol/L, or a calcium level less than 1.5 mmol/L, the development of a life-threatening arrhythmia, or sudden death. RESULTS Laboratory tumor lysis occurred in 42% of patients and clinical tumor lysis in 6%. There was no statistical difference in the frequency of either tumor lysis syndrome among lymphoma subgroups. Clinical tumor lysis occurred more frequently in patients with pretreatment renal insufficiency (serum creatinine level greater than 132 mumol/L) than in patients with normal renal function (36% versus 2%; p = 0.01). The development of azotemia correlated with high pretreatment serum lactate dehydrogenase concentrations (p < 0.01; r2 = 0.11). CONCLUSION Clinically significant tumor lysis is a rare occurrence in patients with lymphoma when they are receiving allopurinol. However, tumor lysis can occur in patients with all types of moderate to high-grade non-Hodgkin's lymphoma. Patients with a high serum lactate dehydrogenase level or renal insufficiency are at increased risk for metabolic complications after chemotherapy and should be closely monitored.
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MESH Headings
- Acute Disease
- Allopurinol/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Blood Urea Nitrogen
- Burkitt Lymphoma/blood
- Burkitt Lymphoma/drug therapy
- Creatinine/blood
- Humans
- Hyperkalemia/etiology
- Hypocalcemia/etiology
- L-Lactate Dehydrogenase/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Lymphoma, Large B-Cell, Diffuse/blood
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Non-Hodgkin/blood
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, T-Cell/blood
- Lymphoma, T-Cell/drug therapy
- Phosphates/blood
- Renal Insufficiency/etiology
- Retrospective Studies
- Risk Factors
- Tumor Lysis Syndrome/blood
- Tumor Lysis Syndrome/etiology
- Uric Acid/blood
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Affiliation(s)
- K R Hande
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
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Abstract
Acute tumor lysis syndrome (ATLS) represents one of the most urgent of all oncologic treatment related complications. This is due not only to its broad impact on organ dysfunction, but also to its relative ease of prevention and treatment when aware of its potential threat. Despite anecdotal experiences of ATLS in settings outside the use of chemotherapy, the majority of patients susceptible to ATLS can be predicted using clinical as well as laboratory parameters and prophylaxis can prevent this potentially lethal consequence of otherwise successful cancer therapeutics. This review article will attempt to bring the critical aspects involving ATLS together in order to delineate the pathophysiology as well as treatment of this generally avoidable entity.
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Affiliation(s)
- D R Fleming
- University of Kentucky, Division of Hematology/Oncology, Markey Cancer Center, Lexington 40536-0084
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O'Connor NT, Prentice HG, Hoffbrand AV. Prevention of urate nephropathy in the tumour lysis syndrome. CLINICAL AND LABORATORY HAEMATOLOGY 1989; 11:97-100. [PMID: 2766676 DOI: 10.1111/j.1365-2257.1989.tb00189.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
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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Affiliation(s)
- N T O'Connor
- Department of Haematology, Royal Free Hospital, London
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18
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Rieselbach RE. Nephrotoxicity Caused by Cancer Chemotherapy. Nephrology (Carlton) 1984. [DOI: 10.1007/978-1-4612-5284-9_76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Gilboa N, Lum GM, Urizar RE. Early renal involvement in acute lymphoblastic leukemia and nonHodgkin's lymphoma in children. J Urol 1983; 129:364-7. [PMID: 6572731 DOI: 10.1016/s0022-5347(17)52099-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Clinical manifestations of kidney disease, particularly renal failure, caused by malignant infiltration in patients with acute lymphoblastic leukemia or nonHodgkin's lymphoma have been described rarely. We report 1 case of acute lymphoblastic leukemia and 3 cases of nonHodgkin's lymphoma in which renal disease was the only or one of the presenting manifestations of malignancy. Of these patients 2 had rapidly progressive renal failure with nephromegaly, 1 presented with bilateral abdominal masses caused by severe nephromegaly and with microscopic hematuria, and 1 had microscopic hematuria without nephromegaly. In all 4 patients kidney biopsy revealed malignant infiltration. In the 2 patients who presented with renal failure kidney function promptly returned to normal after chemotherapy and irradiation of the kidneys. Prompt and correct diagnosis of nephropathy, when it is the only or one of the presenting signs of acute lymphoblastic leukemia or nonHodgkin's lymphoma, is necessary to expedite initiation of specific antitumor therapy.
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Abstract
Various renal complications occur during the course of neoplastic disease. The therapeutic and prognostic implications differ according to the reversibility of both the underlying malignancy and the superimposed complications in the kidney. Since the mechanisms of renal failure vary significantly in patients with different types of malignancy, it is essential to avoid generalizations about etiologic factors or likely outcomes of the disease processes. The pathophysiologic abnormalities should be determined in each patient, and the reversibility of both the neoplastic and problems assessed before therapeutic decisions are made. This often requires a team effort by the internist, oncologist, nephrologist, urologist and, most importantly, the patient.
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Isaacs M, Turnbull AD. Acute renal failure in cancer patients. Curr Probl Cancer 1979; 4:15-25. [PMID: 533640 DOI: 10.1016/s0147-0272(79)80041-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Abstract
The metabolic response to uncomplicated surgery in the patient undergoing primary therapy for malignancy is no different than the response to surgery of similar magnitude for benign disease. Hemodynamic, nutritional-endocrine, and convalescent changes are similar. However, with current aggressive approaches to the management of cancer, the patient often comes to surgery with evidence of major debilitating side effects from his progressive malignancy or from aggressive multimodality therapy. The surgeon must be aware of the consequences of the use of combination therapies on the expected metabolic response to surgery. Awareness of such problems such as the nutritional deficit will allow preventive methods to supercede metabolic salvage procedures.
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Abstract
An 8-year-old boy who presented with recurrent attacks of acute non-oliguric renal failure is described. Hemograms were normal and the kidneys were not enlarged. A renal biopsy was done and diagnosis was acute lymphoblastic leukemia. The etiology of renal failure in leukemia is discussed.
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Lavigne JG, Barry A, d'Auteuil C, Delage JM. P-aminosalicylate metabolism in cancer patients sensitive and resistant to chemotherapy. Br J Cancer 1977; 35:580-6. [PMID: 577182 PMCID: PMC2025501 DOI: 10.1038/bjc.1977.91] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
A reduced response of a tumour to chemotherapy may be due to the host's drug metabolism. To test this hypothesis, we measured the metabolism of a model drug, para-aminosalicylate (PAS). Volunteers and cancer patients ingested a single oral dose (2 g) of PAS and we measured the plasma disappearance curve of the drug and its metabolite. In 7 patients suffering from lymphosarcoma, acute or chronic leukaemia and resistant to cancer chemotherapy, we observed low plasma PAS concentrations, an increase in PAS acetylation and an increased number (and a higher frequency) of abnormal liver-function tests. In 14 patients with malignant blood disease, yet responding well to chemotherapy, the metabolism of PAS is similar to that of healthy controls of the same age and sex. The plasma half-life of PAS is similar in sensitive and resistant patients, but slightly longer than in volunteers. Finally, in urine collected 120 min after drug administration, we observed the same results as in plasma. In conclusion, cancer patients resistant to chemotherapy do not metabolize the model drug PAS as volunteers or sensitive patients do, and this might be relevant to the terminal stage of the disease.
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Abstract
Leukemic infiltration of the kidneys is a very rare cause of renal failure. A woman with acute lymphoblastic leukemia presented with nonliguric renal failure and was found to have massively enlarged kidneys. The size of the kidneys was dramatically reduced through the combined effects of local radiation therapy and systemic chemotherapy. Because this rapid shrinkage of the kidneys was associated with improvement in renal function, the uremia was ascribed to leukemic infiltration. As a consequence of rapid tumor lysis in the presence of renal failure, marked hyperphosphatemia and hypocalcemia developed. The literature experience with renal failure secondary to leukemic infiltration of the kidneys is reviewed.
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Conger JD, Falk SA, Guggenheim SJ, Burke TJ. A micropuncture study of the early phase of acute urate nephropathy. J Clin Invest 1976; 58:681-9. [PMID: 956394 PMCID: PMC333226 DOI: 10.1172/jci108514] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The early pathophysiological changes in acute urate nephropathy were investigated in a rat model using micropuncture, clearance, and morphologic methods. Plasma urate was increased from 1.2 +/- 0.6 to 20.1 +/- 3.1 mg/100 ml (P less than 0.001). Urinary urate rose from 24.3 +/- 5.1 to 142.2 +/- 21.0 mg/100 ml (P less than 0.001). Renal plasma flow and glomerular filtration rate fell to 17 and 14% of control values, respectively, and urine flow rate decreased from 11.3 +/- 4.8 to 4.2 +/- 2.2 mul/min (all P less than 0.005) Superficial nephron filtration rate fell less than that of the whole kidney (70 vs. 86%). Both proximal and distal tubular pressures were increased from 10.6 to 26.1 mm Hg and from 7.2 to 24.7 mm Hg, respectively (P less than 0.005). Efferent arteriolar and peritubular capillary pressures were increased twofold. Vascular resistance beyond the peritubular capillaries increased from 4.8 X 10(9) to 21.6 X 10(9) dynes s/cm5. Extensive deposits of uric acid and urate were found in the tubular system and vasa recti from the corticomedullary junction to the tip of the papilla. It is concluded from these experiments that not only tubular obstruction in the collecting ducts, but also obstruction of the distal renal vasculature, are the primary early pathogenetic events in acute urate nephropathy.
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Abstract
The first cases of malignant lymphoma with a "myeloma kidney" type of acute renal failure are presented. With appropriate therapy, both patients regained partial renal function; the first after three months of dialysis. It is suggested that the term paraproteinemic nephropathy is preferable to "myeloma kidney."
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Morel-Maroger L, Basch A, Danon F, Verroust P, Richet G. Pathology of the kidney in Waldenström's macroglobulinemia. Study of sixteen cases. N Engl J Med 1970; 283:123-9. [PMID: 4987279 DOI: 10.1056/nejm197007162830304] [Citation(s) in RCA: 112] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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al-Rashid RA, Call JE. Hyperuricemia complicating acute leukemia. Case reports and comments on therapy. Clin Pediatr (Phila) 1970; 9:203-5. [PMID: 5441843 DOI: 10.1177/000992287000900408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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31
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Steele TH, Present CA, Serpick AA. A reversible concentrating defect in predominantly unilateral renal Hodgkin's disease. Am J Med 1970; 48:375-81. [PMID: 5435649 DOI: 10.1016/0002-9343(70)90068-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Klipstein FA, Smarth G. Intestinal structure and function in neoplastic disease. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1969; 14:887-99. [PMID: 5361083 DOI: 10.1007/bf02233210] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Carlson DJ, Jones B. Uric acid nephropathy complicating acute leukemia in children. Personal cases, pathogenesis, management and prevention. Clin Pediatr (Phila) 1966; 5:736-42. [PMID: 5927108 DOI: 10.1177/000992286600501211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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37
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DeConti RC, Calabresi P. Use of allopurinol for prevention and control of hyperuricemia in patients with neoplastic disease. N Engl J Med 1966; 274:481-6. [PMID: 5904287 DOI: 10.1056/nejm196603032740902] [Citation(s) in RCA: 97] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Watts RW, Watkins PJ, Matthias JQ, Gibbs DA. Allopurinal and acute uric acid nephropathy. BRITISH MEDICAL JOURNAL 1966; 1:205-8. [PMID: 5901729 PMCID: PMC1843384 DOI: 10.1136/bmj.1.5481.205] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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RIESELBACH RE, BENTZEL CJ, COTLOVE E, FREI E, FREIREICH EJ. URIC ACID EXCRETION AND RENAL FUNCTION IN THE ACUTE HYPERURICEMIA OF LEUKEMIA. PATHOGENESIS AND THERAPY OF URIC ACID NEPHROPATHY. Am J Med 1964; 37:872-83. [PMID: 14246089 DOI: 10.1016/0002-9343(64)90130-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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