acute tumor lysis syndrome and treatment response in patients treated for refractory chronic lymphocytic leukemia with short-course, high-dose cytosine arabinoside, cisplatin, and etoposide

摘要: Acute tumor lysis syndrome resulting from rapid neoplastic cell after chemotherapy is an unusual event, generally seen in histological aggressive lymphatic tumors. The authors saw four patients who developed acute when treated for advanced-stage, refractory chronic lymphocytic leukemia (CLL) with initial cycle of cytosine arabinoside (Ara-C) 2 g/m2 every 12 hours x 4, cisplatin 35 mg/m2 24 2, and etoposide 100 (ACE). With hydration, urine alkalinization, forced diuresis, high-dose allopurinol, was not three subsequent cases CLL ACE. Of a total eight treated, seven had marked reductions lymphocyte counts the first course patients, are alive: one complete remission greater than years, partial cycles ACE, Richter's transformation to large lymphoma. remaining died ACE chemotherapy, as direct complication pancytopenia, others complications severe pancytopenia general debilitation. Therefore, appears cause dissolution cells CLL, appropriate management infectious may have favorable impact on survival advanced CLL.