A rare case of tumour lysis syndrome in multiple myeloma
DOI:
https://doi.org/10.18203/2349-3933.ijam20230371Keywords:
Mutiple myeloma, Tumour lysis syndrome, BortezomibAbstract
Tumour lysis syndrome (TLS) is a serious life-threatening complication of cancer chemotherapy which is a constellation of metabolic disturbances that typically occurs during therapy of bulky, rapidly proliferative tumours. TLS is an oncological emergency that causes a significant release of phosphate, potassium, uric acid, and nucleic acids into the blood stream. Incidence of TLS in multiple myeloma is rare. Here we present a case of multiple myeloma who later developed tumour lysis syndrome in its due course which was rare. A 67-year-old male was diagnosed with Multiple myeloma on the basis of M spike, osteolytic lesions and bone marrow analysis. First cycle of chemotherapy with lenalidomide, bortezomib and denosumab was initiated. During the course of follow up he presented to our casualty with complaints of chills and rigor. Based on the biochemical abnormalities a diagnosis of tumour lysis syndrome was made. He received I.V fluids, anti-hyperkalemic measures, allopurinol. He had neutropenic sepsis and went into septic shock and died after multiple resuscitative efforts.
Metrics
References
Hochberg J, Cairo MS. Tumor lysis syndrome: current perspective. Haematologica. 2008;93(1):9-13.
Coiffier B, Altman A, Pui C-H, Younes A, Cairo MS. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol. 2008;26(16):2767-78.
Fassas AB, Desikan KR, Siegel D, Golper TA, Munshi NC, Barlogie B, et al. Tumour lysis syndrome complicating high-dose treatment in patients with multiple myeloma. Br J Haematol. 1999;105(4):938-41.
Cairo MS, Coiffier B, Reiter A, Younes A. Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus. Br J Haematol. 2010;149(4):578-86.
Chang H, Lee SY, Tang TC. Tumor lysis syndrome in patients with light chain multiple Myeloma: report of two cases. Chang Gung Med J. 2011;34(6):70-5.
Abu Alfa AK, Younes A. Tumor lysis syndrome and acute kidney injury: Evaluation, prevention, and management. Am J Kidney Dis. 2010;55(3):S1-13.
Williams SM, Killeen AA. Tumor Lysis Syndrome. Arch Pathol Lab Med. 2019;143(3):386-93.
Belay Y, Yirdaw K, Enawgaw B. Tumor Lysis Syndrome in Patients with Hematological Malignancies. J Oncol. 2017;9684909.
Crittenden DR, Ackerman GL. Hyperuricemic acute renal failure in disseminated carcinoma. Arch Intern Med. 1977;137(1):97-9.
Terpos E, Politou M, Rahemtulla A. Tumour lysis syndrome in multiple myeloma after bortezomib (VELCADE) administration. J Cancer Res Clin Oncol. 2004;130:623 5.
Kenealy MK, Prince HM, Honemann D. Tumor lysis syndrome early after treatment with bortezomib for multiple myeloma. Pharmacotherapy. 2006;26:1205 6.
Jones GL, Will A, Jackson GH. British Committee for Standards in H. Guidelines for the management of tumour lysis syndrome in adults and children with haematological malignancies on behalf of the British Committee for Standards in Haematology. Br J Haematol. 2015;169(5):661-71.
Downloads
Published
How to Cite
Issue
Section
