TY - JOUR
T1 - Massive hyperphosphatemia in clinical tumor lysis syndrome during prophylactic rasburicase use
T2 - risk factors and treatment options
AU - Kikuchi, Shohei
AU - Muro, Makiko
AU - Kamihara, Yusuke
AU - Wada, Akinori
AU - Murakami, Jun
AU - Nabe, Yoshimi
AU - Minemura, Tomoki
AU - Sato, Tsutomu
N1 - © The Author(s) under exclusive licence to The Japan Society of Clinical Oncology 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
PY - 2023/1
Y1 - 2023/1
N2 - We report the case of a 76-year-old female with diffuse large B cell lymphoma who developed tumor lysis syndrome (TLS) and subsequent acute kidney injury (AKI) due to massive hyperphosphatemia during the prophylactic use of rasburicase. Our case showed no hyperphosphatemia before chemotherapy but had elevated uric acid and creatinine levels and unilateral hydronephrosis due to paraaortic lymphadenopathy. TLS risk was classified as high risk because of bulky mass, LDH elevation, and renal disturbance. With rasburicase use, uric acid was completely controlled but massive hyperphosphatemia and, subsequently, AKI developed. Immediate kidney replacement therapy led to improvement of hyperphosphatemia and AKI. In the rasburicase era, hyperphosphatemia has been a key target for preventing and treating TLS. Renal replacement therapy is the only effective option for lowering hyperphosphatemia and treating AKI.
AB - We report the case of a 76-year-old female with diffuse large B cell lymphoma who developed tumor lysis syndrome (TLS) and subsequent acute kidney injury (AKI) due to massive hyperphosphatemia during the prophylactic use of rasburicase. Our case showed no hyperphosphatemia before chemotherapy but had elevated uric acid and creatinine levels and unilateral hydronephrosis due to paraaortic lymphadenopathy. TLS risk was classified as high risk because of bulky mass, LDH elevation, and renal disturbance. With rasburicase use, uric acid was completely controlled but massive hyperphosphatemia and, subsequently, AKI developed. Immediate kidney replacement therapy led to improvement of hyperphosphatemia and AKI. In the rasburicase era, hyperphosphatemia has been a key target for preventing and treating TLS. Renal replacement therapy is the only effective option for lowering hyperphosphatemia and treating AKI.
U2 - 10.1007/s13691-022-00580-9
DO - 10.1007/s13691-022-00580-9
M3 - 学術論文
C2 - 36605847
SN - 2192-3183
VL - 12
SP - 69
EP - 74
JO - International cancer conference journal
JF - International cancer conference journal
IS - 1
ER -