Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  29 (2025)
Volume  28 (2024)
Volume  27 (2023)
Volume  26 (2022)
Volume  25 (2021)
Volume  24 (2020)
Volume  23 (2019)
Volume  22 (2018)
Volume  21 (2017)
Volume  20 (2016)
Volume  19 (2015)
Volume  18 (2014)
Volume  17 (2013)
Volume  16 (2012)
Volume  15 (2011)
Volume  14 (2010)
Volume  13 (2009)
Volume  12 (2008)
Volume  11 (2007)
Volume  10 (2006)
Volume  9 (2005)
Volume  8 (2004)
Related articles

VOLUME 11 , ISSUE 1 ( January, 2007 ) > List of Articles

REVIEW ARTICLE

Preventing acute renal failure is crucial during acute tumor lysis syndrome

Guillaume Thiery, Elie Azoulay, Michael Darmon

Keywords : Acute renal failure, hyperkalemia, hyperphosphatemia, hyperuricemia, intensive care unit, leukemia, non-Hodgkin′s lymphoma, urate nephropathy

Citation Information : Thiery G, Azoulay E, Darmon M. Preventing acute renal failure is crucial during acute tumor lysis syndrome. Indian J Crit Care Med 2007; 11 (1):29-35.

DOI: 10.4103/0972-5229.32434

License: CC BY-ND 3.0

Published Online: 01-01-2011

Copyright Statement:  Copyright © 2007; The Author(s).


Abstract

Tumour Lysis syndrome (TLS) is characterized by the massive destruction of tumoral cells and the release in the extracellular space of their content. While TLS may occur spontaneously before treatment, it usually develops shortly after the initiation of cytotoxic chemotherapy. These metabolites can overwhelm the homeostatic mechanisms and cause hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. Moreover, TLS may lead to an acute renal failure (ARF). In addition to the hospital mortality induced by the acute renal failure itself, development of an ARF may preclude optimal cancer treatment. Therefore, prevention of the acute renal failure during acute tumor lysis syndrome is mandatory. The objective of this review is to describe pathophysiological mechanisms leading to acute tumor lysis syndrome, clinical and biological consequences of this syndrome and to provide up-to-date guidelines to ensure prevention and prompt management of this syndrome.

PDF Share
  1. The intensive care support of patients with malignancy: Do everything that can be done. Intensive Care Med 2006;32:3-5.
  2. Outcome in severely ill patients with hematological malignancies who received intravenous chemotherapy in the intensive care unit. Intensive Care Med 2006;32:93-9.
  3. Intensive care in patients with newly diagnosed malignancies and a need for cancer chemotherapy. Crit Care Med 2005;33:2488-93.
  4. Acute monocytic leukemia presenting as acute respiratory failure. Am J Respir Crit Care Med 2003;167:1329-33.
  5. Bulky disease is the most important prognostic factor in Hodgkin lymphoma stage IIB. Eur J Haematol 2003;71:327-33.
  6. Macular haemorrhage in adult acute leukaemia patients at presentation and the risk of subsequent intracranial haemorrhage. Br J Haematol 1997;98:204-9.
  7. Lymphomas diagnosed by percutaneous kidney biopsy. Am J Kidney Dis 2003;42:960-71.
  8. Tumour lysis syndrome: New therapeutic strategies and classification. Br J Haematol 2004;127:3-11.
  9. Pathophysiology, clinical consequences and treatment of tumor lysis syndrome. Am J Med 2004;116:546-54.
  10. Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients. Crit Care Med 2002;30:2051-8.
  11. Hemodialysis for acute renal failure in patients with hematologic malignancies. Crit Care Med 1991;19:346-51.
  12. Outcome in critically ill medical patients treated with renal replacement therapy for acute renal failure: Comparison between patients with and those without haematological malignancies. Nephrol Dial Transplant 2005;20:552-8.
  13. Renal complications in acute leukemias. Haematologica 1998;83:416-21.
  14. Acute tumor lysis syndrome. Semin Oncol 2001;28:3-8.
  15. A review of clinical and laboratory findings and treatment of tumor lysis syndrome. Clin Chim Acta 2003;333:13-8.
  16. Biochemistry of uric acid and its relation to gout. N Engl J Med 1963;268:821-7.
  17. Biochemistry of uric acid and its relation to gout. N Engl J Med 1963;268:764-73.
  18. Biochemistry of uric acid and its relation to gout. N Engl J Med 1963;268:712-6.
  19. Tubular secretion of urate in man. J Clin Invest 1959;38:1778-81.
  20. The renal mechanism for urate excretion in man. J Clin Invest 1950;29:396-401.
  21. Intrarenal dynamics in the pathogenesis and prevention of acute urate nephropathy. J Clin Invest 1977;59:786-93.
  22. The effectiveness of the xanthine oxidase inhibitor allopurinol in the treatment of gout. Ann Intern Med 1965;62:639-47.
  23. Metabolic emergencies in the cancer patient. Semin Oncol 2000;27:322-34.
  24. Studies of the mechanism by which phosphate infusion lowers serum calcium concentration. J Clin Invest 1966;45:1886-94.
  25. Increased lactate production follows loss of mitochondrial membrane potential during apoptosis of human leukaemia cells. Br J Haematol 2001;114:574-80.
  26. Clinical features of non-Hodgkins lymphoma presenting with acute liver failure: A report of five cases and review of published experience. Am J Gastroenterol 2003;98:1641-6.
  27. Tumor lysis syndrome. Semin Hematol 2001;38:4-8.
  28. Acute tumor lysis syndrome. A review of 37 patients with Burkitt′s lymphoma. Am J Med 1980;68:486-91.
  29. Urate oxidase in the prophylaxis or treatment of hyperuricemia: The United States experience. Semin Hematol 2001;38:13-21.
  30. A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis. Blood 2001;97:2998-3003.
  31. Tumor lysis syndrome in small cell carcinoma and other solid tumors. Am J Med 1997;103:363-7.
  32. Tumor lysis syndrome (TLS) following fludarabine therapy for chronic lymphocytic leukemia (CLL): Case report and review of the literature. Am J Hematol 2003;72:212-5.
  33. Tumour lysis syndrome complicating high-dose treatment in patients with multiple myeloma. Br J Haematol 1999;105:938-41.
  34. Tumour lysis syndrome in multiple myeloma after bortezomib (VELCADE) administration. J Cancer Res Clin Oncol 2004;130:623-5.
  35. Tumor lysis syndrome occurring after the administration of rituximab in lymphoproliferative disorders: High-grade non-Hodgkin′s lymphoma and chronic lymphocytic leukemia. Am J Hematol 1999;62:247-50.
  36. Tumor lysis syndrome at the beginning of thalidomide therapy for multiple myeloma. J Clin Oncol 2002;20:2212.
  37. Acute tumor lysis syndrome after thalidomide therapy in advanced hepatocellular carcinoma. Oncologist 2006;11:87-8.
  38. Tumor lysis syndrome after tamoxifen flare. N Engl J Med 1986;315:263-4.
  39. Tumour lysis syndrome in a patient with metastatic melanoma treated with biochemotherapy. Nephrol Dial Transplant 2001;16:188-9.
  40. Renal failure associated with cancer and its treatment: An update. J Am Soc Nephrol 2005;16:151-61.
  41. Diuretics, mortality and nonrecovery of renal function in acute renal failure. JAMA 2002;288:2547-53.
  42. Alkalinization and the tumor lysis syndrome. Med Pediatr Oncol 1998;31:27-8.
  43. Efficacy and safety of rasburicase (recombinant urate oxidase) for the prevention and treatment of hyperuricemia during induction chemotherapy of aggressive non-Hodgkin′s lymphoma: Results of the GRAAL1 (Groupe d′Etude des Lymphomes de l′Adulte Trial on Rasburicase Activity in Adult Lymphoma) study. J Clin Oncol 2003;21:4402-6.
  44. Acute tumor lysis syndrome in solid tumors- a case report and review of the literature. Cancer Chemother Pharmacol 2003;51:187-92.
  45. The spectrum of acute renal failure in tumour lysis syndrome. Nephrol Dial Transplant 1999;14:776-9.
  46. Pan-European multicentre economic evaluation of recombinant urate oxidase (rasburicase) in prevention and treatment of hyperuricaemia and tumour lysis syndrome in haematological cancer patients. Support Care Cancer 2003;11:249-57.
  47. Hemolysis and methemoglobinemia secondary to rasburicase administration. Ann Pharmacother 2005;39:1932-5.
  48. Rapid tumor lysis in a patient with B-cell chronic lymphocytic leukemia and lymphocytosis treated with an anti-CD20 monoclonal antibody (IDEC-C2B8, rituximab). Ann Hematol 1998;77:89-91.
  49. Fatal acute tumor lysis syndrome, hepatic encephalopathy and flare phenomenon following combined androgen blockade. J Urol 2004;171:1627.
  50. Spontaneous tumor lysis syndrome in solid tumors: Really a rare condition? Am J Med Sci 2003;325:38-40.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.