Volume : IX, Issue : IX, September - 2019

Management of Tumour Lysis Syndrome without Rasburicase: A Model for the Developing World

Priyadarshini Kowtal, Anand Prakash

Abstract :

Background: Tumor lysis syndrome (TLS) is a common oncological emergency during the treatment of hematolymphoid malignancies. Rasburicase is recommended in the prevention and treatment of TLS but is an expensive medication. Aim: Evaluate a protocol for management of TLS without rasburicase in a developing country context. Methods: Prospective observational study of children with hematolymphoid malignancies to evaluate for laboratory and clinical TLS was conducted. All the patients at risk for developing TLS were included in the study and treatment was initiated as per our protocol. The patients were categorised based on TLS risk stratification and Cairo–Bishop score. Results: 60 patients were recruited in the study. Forty three had ALL, 9 had AML, 8 had NHL. 37 were classified as high risk, 19 as intermediate and 4 as low risk for TLS. 12 developed hyperuricemia, 7 had hyperphosphatemia, 4 had hypocalcemia and 4 had hyperkalemia. Chemotherapy was delayed due to renal dysfunction in only one patient. Three required PICU care and only one required dialysis. There was no mortality. Conclusion: Judicious hydration, allopurinol, phosphate binders, diuretics and frequent laboratory monitoring was used in all our patients. We have an excellent outcome even in the high risk group despite not using rasburicase.

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Article: Download PDF    DOI : 10.36106/ijar  

Cite This Article:

MANAGEMENT OF TUMOUR LYSIS SYNDROME WITHOUT RASBURICASE: A MODEL FOR THE DEVELOPING WORLD, Priyadarshini Kowtal, Anand Prakash INDIAN JOURNAL OF APPLIED RESEARCH : Volume-9 | Issue-9 | September-2019

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