The role of hypercytokinemia in the pathophysiology of tumor lysis syndrome (TLS) and the treatment with continuous hemodiafiltration using a polymethylmethacrylate membrane hemofilter (PMMA-CHDF).

摘要: Abstract Objective To examine the role of hypercytokinemia in pathophysiology tumor lysis syndrome (TLS) and efficacy continuous hemodiafiltration treatment TLS. Design setting Retrospective observational study a general intensive care unit university hospital. Patients Four patients with hematological disorder developing TLS after anti-tumor chemotherapy. Interventions Continuous using polymethylmethacrylate membrane hemofilter (PMMA-CHDF) was performed at onset Blood samples were collected daily ICU admission, clinical parameters blood levels cytokines evaluated. Measurements results All four underwent induction chemotherapy, during which they developed hyperuricemia, hyperkalemia, acute renal failure. Two them also multiple organ Serum necrosis factor (TNF) -alpha, interleukin-6 (IL-6), IL-10 prior to initiation PMMA-CHDF 102±85pg/mL, 1097±546pg/mL, 98±83pg/mL, respectively (mean ± SD). After three days treatment, corresponding 37±55pg/mL, 326±511pg/mL, 9±8pg/mL, respectively. Thus, all cytokine significantly decreased by ( p t -test). Following urea nitrogen (BUN) serum creatinine (Cre.) (pre/post BUN 42.3±15.4/16.5±8.4mg/dL, Conclusion Hypercytokinemia plays pivotal may be an effective therapeutic modality for not only as replacement therapy but modulator.