ICU SAQs · Haematology / oncology
Tumour lysis syndrome post-chemotherapy — rasburicase and the prophylaxis
A CICM SAQ on TLS — high-risk Burkitt lymphoma, prophylaxis (hydration plus rasburicase), and treatment (rasburicase, hyperkalaemia, RRT).
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Prompt
A 30-year-old with the Burkitt lymphoma, the WCC 80, is about to start chemotherapy. Discuss the TLS prophylaxis and the management if it develops.
Question
A 30-year-old with the Burkitt lymphoma, the WCC 80, is about to start chemotherapy. Discuss the TLS prophylaxis and the management if it develops.[1]
References5ShowHide
- [1]Cairo MS, Bishop M Tumour lysis syndrome: new therapeutic strategies and classification Br J Haematol, 2004.PMID 15384972
- [2]Coiffier B, Altman A, Pui CH, Younes A, Cairo MS Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review J Clin Oncol, 2008.PMID 18509186
- [3]Cortes J, Moore JO, Maziarz RT, et al Control of plasma uric acid in adults at risk for tumor Lysis syndrome: efficacy and safety of rasburicase alone and rasburicase followed by allopurinol compared with allopurinol alone--results of a multicenter phase III study J Clin Oncol, 2010.PMID 20713865
- [4]Hammami MB, et al. Rasburicase-induced hemolytic anemia and methemoglobinemia: a systematic review of current reports Ann Hematol, 2024.PMID 37468669
- [5]Dinnel J, et al. Rasburicase in the management of tumor lysis: an evidence-based review of its place in therapy Core Evid, 2015.PMID 25610345