AFAMS Antineoplastics and Immunomodulating Agents EO 003.01 Part 24.
Antineoplastics
Transcript of Antineoplastics
Reactions 1295 - 3 Apr 2010
SAntineoplastics
Fatal tumour lysis syndrome: case reportA 33-year-old man developed multicentric tumour lysis
syndrome while receiving antineoplastics for giant lymphnode hyperplasia; he subsequently died.
Following hospitalisation and diagnosis with giant lymphnode hyperplasia, prednisolone 1 mg/kg/day wascommenced. On day 7 of treatment, he was discharged inan improved condition. Eighteen days after treatment [timeto reaction onset not clearly stated], he was readmitted withfever and pancytopenia. On hospital day 4, he was initiatedon cyclophosphamide 800 mg/m2, vincristine 1.4 mg/m2 onday 1, and prednisolone 1 mg/kg for 5 days (CVP regimen).On the sixth day of chemotherapy, he was stillpancytopenic and had a high fever. Four days later, he wasstarted on dexamethasone 40mg [dose frequency notstated]. The next day, (14 hours post-infusion), he becamesuddenly dyspnoeic, with a heart rate of 116bpm,respiratory rate of 33 breaths/minute and BP of130/70mm Hg. His levels of serum creatinine, phosphorus,potassium, uric acid and liver enzymes were elevated, andhe displayed severe acidosis.
The man was commenced on a continuous furosemideinfusion and fluids. His oliguric renal failure showed noimprovement, despite continuous renal replacementtherapy. Progressive multiple organ failure andhypotension led to his death, on day 17 of chemotherapytreatment.Lee JH, et al. Multicentric Castleman disease complicated by tumor lysis syndromeafter systemic chemotherapy. Leukemia Research 34: e42-e45, No. 1, Jan 2010.Available from: URL: http://dx.doi.org/10.1016/j.leukres.2009.08.025 - SouthKorea 803009441
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