All issues > Volume 27(3); 1984

Case Report

J Korean Pediatr Soc. 1984;27(3):303-312. Published online March 31, 1984.

Acute Tumor Lysis Syndrome.

Sun Oak Park, In Sil Lee, Hyp Seop Ahn, Yong Choi

¹Department of Pediatrics, Seoul National University Hospital

Abstract

To assess the incidence and the effectiveness of preventive measures for tumor lysis syndrome, we analyzed the serial electrolytes levels in leukemia (Group A, 15 patients) and in lymphoma (Group B, 8 patients) patients. The results were 1)Serum LDH were elevated in all of the patients before the chemotherapy. 2)Serum uric acid were also elevated in 8 patients (A 5, B 3) before the chemotherapy and no patient showed further increment after the chemotherapy except one in Group A. 3)Hypercalcemia was observed only in Group A (2 patients), and hypocalcem ia was observed in 7 patients (A 5, B 2). 4)Hyperphosphatemia was found in 5 patients from only group A, while 5 patients from Group B showed hypophosphatemia. 5) The elevation of serum Cr was observed in 10 patients (A 8, B 2), but only one patient from Group A showed the persistent elevation. From the above results we concluded 1)Preventive measures (Allopurinol, Hydration, Alkalinization) for the elevation of uric acid by acute tumor lysis were very effective. 2)Hypercalcemia and hyperphosphatemia were observed only in leukemic patients, while lymphoma patients showed hypophosphatemia. 3)Because of the significant numbers of patients showed the abnormalities of serum electrolytes even before the chemotherapy (Figure 9, 10), early detection of the malignancy seems to be the most important not only for the treatment of cancer itself, but also for the prevention of tumor lysis syndrome.

Keywords :Tumor Lysis Syndrome; LDH; Hyperuricemia; Hyperclacemia; Hypocalcemia;Hyperphosphatemia;Hypophosphatemia; Serum Creatinine