Журнал клинических случаев

Spontaneous Fatal Tumor Lysis Syndrome in a Patient with T-Cell Lymphoblastic Lymphoma/Leukemia: Successful Treatment with Continuous Renal Replacement Therapy and Increasing-Dose Gradually Chemotherapy

Abstract

Jing-Hua Liu, Fan Zhou, Xiao-Lin Zhang, Yan-Qin Liu, Ji-Gang Wang and Ying Bai

Tumor Lysis Syndrome (TLS) results from massive necrosis orapoptosis of large proliferating tumors and is characterized by marked hyper uricemia, hyperkalemia, and hyper phosphatemia secondaryto cell lysis and the metabolism of excessive nucleic acids. Clinically significant TLS, with end-organ compromise, occurs in approximately5% of all patients with hematologic malignancies and in up to 25% of highrisk patients, including those with T-cell acute lymphoblasticleukemia and Burkitt’s lymphoma. TLS is a phenomena frequently occurs after the initiation of therapy, while spontaneous TLS occurringin the absence of chemotherapy, is rare but might portend a worse prognosis. We present a case of spontaneous TLS treated successfullywith continuous renal replacement therapy and increasing-dosegradually chemotherapy in a boy with T-cell lymphoblastic lymphoma/leukemia.