Abstract

Objectives:  This study was conducted to determine the prevalence of tumor lysis syndrome (TLS) in patients of acute leukemia and lymphoreticular malignancies (Lymphoma).

Materials and Methods: The present study was conducted at Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak and data was collected bynon-probability convenient sampling from hundred patients (age 14 years or above) of Acute Leukemia or Lymphoma in Haematology Department of Medicine over a period of one year. Patients satisfying inclusion criteria were monitored for development of tumor lysis syndrome. Starting from day of admission till completion of 4 weeks of induction therapy in leukemia patients following parameters (Serum Uric Acid, Serum Potassium, Serum Phosphorus, Serum Calcium, Blasts and TLC) were monitored on alternate day to see for development of TLS. Starting from day of admission, monitoring of same parameters was done on day 1 and day 2of each cycle of lymphoma patients for TLS. If Tumor Lysis Syndrome developed (Grade II or more) then monitoring was done on each day till remission. All patients  received  adequate hydration,   allopurinol  and induction chemotherapy. Data were analysed by statistical package for social sciences (SPSS) version16.0.

Results: Out of 100 patients 19 fulfilled the criteria for TLS.In acute leukemia group 10 (28.57%) patients developed TLS of which 5 patients (14.3%) had spontaneous tumor lysis syndrome, 4 patients (11.4%) had laboratory tumor lysis syndrome and only one patient (2.9%) had clinical tumor lysis syndrome. Among lymphoma group no patient developed spontaneous or clinical tumor lysis syndrome. Only laboratory tumor lysis syndrome was seen in 9 (13.8%) out of 65 patients of lymphoma. Overall one patient died because of TLS. Hyperuricemia and Hyperkalemia were the most prominent findings in patients with tumor lysis syndrome.

Conclusion: It is concluded that 19% of the patients developed TLS (including both laboratory and clinical TLS) and despite all measures of prevention it can occur and result in devastating clinical effects.

Keywords: Tumor lysis syndrome, hyperuricemia, hyperphosphatemia, hypocalcaemia, acute renal failure.