Tumor lysis syndrome primary prevention: Difference between revisions
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==Prevention== | ==Prevention== | ||
Before initiating chemotherapy for cancer patients, especially lymphomas and leukemias, patients should receive the following: | Before initiating chemotherapy for cancer patients, especially lymphomas and leukemias, patients should receive the following:<ref name="JonesWill2015">{{cite journal|last1=Jones|first1=Gail L|last2=Will|first2=Andrew|last3=Jackson|first3=Graham H|last4=Webb|first4=Nicholas J A|last5=Rule|first5=Simon|title=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|journal=British Journal of Haematology|volume=169|issue=5|year=2015|pages=661–671|issn=00071048|doi=10.1111/bjh.13403}}</ref> | ||
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Patient population}} | |||
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Treatment}} | |||
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Low risk | |||
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*Adequate [[intravenous]] hydration to maintain a high urine output (> 2.5 L/day) | |||
*Alkalinization of urine is not recommended.<ref name="pmid9607427">{{cite journal| author=Ten Harkel AD, Kist-Van Holthe JE, Van Weel M, Van der Vorst MM| title=Alkalinization and the tumor lysis syndrome. | journal=Med Pediatr Oncol | year= 1998 | volume= 31 | issue= 1 | pages= 27-8 | pmid=9607427 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9607427 }} </ref> | |||
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Intermediate risk | |||
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*[[Allopurinol]] | *[[Allopurinol]] | ||
* | :*Adults dosing: 200-400mg/m2/day in 1-3 divided doses; maximum dose is 800mg/day | ||
* | :*Infants weighing less than 10kg: 3.3mg/kg every 8 hours | ||
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High risk | |||
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*[[Rasburicase]] | |||
:*0.2mg/kg for 5-7 days | |||
:*A single dose of 3 mg may be used in high risk patients | |||
:*Contraindicated in patients with glucose 6 phosphate dehydrogenase ([[G6PD]]) deficiency | |||
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==References== | ==References== | ||
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[[Category:Blood]] | [[Category:Blood]] | ||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] |
Latest revision as of 17:27, 27 November 2017
Tumor lysis syndrome Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]
Overview
Effective measures for the primary prevention of tumor lysis syndrome include allopurinol, rasburicase, and intravenous hydration.
Prevention
Before initiating chemotherapy for cancer patients, especially lymphomas and leukemias, patients should receive the following:[1]
Patient population | Treatment |
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Low risk |
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Intermediate risk |
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High risk |
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References
- ↑ Jones, Gail L; Will, Andrew; Jackson, Graham H; Webb, Nicholas J A; Rule, Simon (2015). "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". British Journal of Haematology. 169 (5): 661–671. doi:10.1111/bjh.13403. ISSN 0007-1048.
- ↑ Ten Harkel AD, Kist-Van Holthe JE, Van Weel M, Van der Vorst MM (1998). "Alkalinization and the tumor lysis syndrome". Med Pediatr Oncol. 31 (1): 27–8. PMID 9607427.