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:<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> | 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> | ||
*[[Allopurinol]] | *Low risk patients: | ||
*[[Rasburicase]] | :*Adequate [[intravenous]] hydration to maintain a high urine output (> 2.5 L/day) | ||
:* | :*Alkalinization of the urine with 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> | ||
*Intermediate risk patients: | |||
:*[[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 | |||
*High risk patients: | |||
:*[[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 | :*Contraindicated in patients with glucose 6 phosphate dehydrogenase ([[G6PD]]) deficiency | ||
==References== | ==References== | ||
Revision as of 16:16, 30 September 2015
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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]
- Low risk patients:
- Adequate intravenous hydration to maintain a high urine output (> 2.5 L/day)
- Alkalinization of the urine with is not recommended.[2]
- Intermediate risk patients:
-
- 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
- High risk patients:
- 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
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.