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Br J Haematol 2019 Feb 15. Epub 2019 Feb 15.

Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Venetoclax is a BCL2 inhibitor with activity in relapsed/refractory (R/R) chronic lymphocytic leukaemia (CLL). We conducted a multi-centre retrospective analysis of 105 R/R CLL patients who received venetoclax pre-National Health Service commissioning. The median age was 67 years and median prior lines was 3 (range: 1-15). Read More

Curr Opin Pediatr 2019 Feb 11. Epub 2019 Feb 11.

Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Purpose Of Review: Chimeric antigen receptor -(CAR) T-cell therapy has become a commonly used immunotherapy originally used in the treatment of B-cell leukemias but which are now applied broadly across tumor classes. Although high rates of remission are associated with CAR T-cell therapy, toxicities associated with these novel treatment regimens can be lethal if not recognized in a timely manner.

Recent Findings: Cytokine release syndrome and neurotoxicity are the two most common toxicities associated with CAR T-cell therapy. Read More

Br J Haematol 2019 Feb 10. Epub 2019 Feb 10.

Peter MacCallum Cancer Centre and St. Vincent's Hospital, Melbourne, Australia.

Diagn Pathol 2019 Feb 9;14(1):16. Epub 2019 Feb 9.

Brain Cancer Program, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1550 Orleans Street, 1M16, Baltimore, MD, 21287, USA.

Background: Gliomas with 1p/19q-codeletion as well as mutation of isocitrate dehydrogenase (IDH) 1 are typically characterized as oligodendrogliomas with comparatively good response to treatment with radiation and chemotherapy.

Case Presentation: We present the case of a 28-year-old man with an IDH1 and TP53 mutant high grade glioma with abnormalities in chromosomes 1 and 19 suggestive of anaplastic oligodendroglioma that rapidly progressed to widespread metastatic disease. Biopsy of a liver lesion confirmed metastasis of the patient's known brain primary and chemotherapy with temozolomide was initiated. Read More

Am J Case Rep 2019 Feb 3;20:146-150. Epub 2019 Feb 3.

Department of Hemato-Oncology, Chosun University Hospital, Gwangju, South Korea.

BACKGROUND Tumor lysis syndrome (TLS) is an oncologic emergency resulting from the massive destruction of tumor cells after cytotoxic chemotherapy for chemosensitive malignancies with a high tumor burden. Its clinical manifestations include severe electrolyte disturbances, metabolic acidosis, acute renal failure secondary to urate deposition in the kidney, heart, and skeletal muscle, and nervous system dysfunction. We report an extremely rare case of spontaneous TLS (STLS) in idiopathic primary myelofibrosis (PMF). Read More

J Oncol Pract 2019 Feb 23;15(2):e178-e186. Epub 2019 Jan 23.

1 University of Texas Southwestern Medical Center, Dallas, TX.

Background:: Rasburicase is a recommended treatment of tumor lysis syndrome and patients at high-risk for developing tumor lysis syndrome. Unfortunately, it is expensive, and unnecessary use raises costs of care.

Methods:: Plan, Do, Study, Act methodology was used to decrease the inappropriate use of rasburicase. Read More

Br J Clin Pharmacol 2019 Jan 22. Epub 2019 Jan 22.

Australian Centre for Pharmacometrics, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia.

Aims: Lenalidomide is an immunomodulatory imide drug (IMiD) used broadly in the treatment of multiple myeloma and lymphoma. It continues to be evaluated in chronic lymphocytic leukaemia (CLL) at lower doses due to dose-related toxicities including tumour flare and tumour lysis syndrome. This study aimed to develop a population pharmacokinetic model for lenalidomide in multiple cancers, including CLL, to identify any disease-related differences in disposition. Read More

Bone Rep 2019 Jun 28;10:100194. Epub 2018 Dec 28.

Division of Endocrinology and Metabolism, Department of Medicine, Zuckerberg San Francisco General Hospital, United States of America.

Hypercalcemia in HIV patients has been previously reported, but 1,25-(OH) vitamin D-mediated hypercalcemia, due to increased activity of extrarenal 1-alpha hydroxylase, is rarely described with HIV-related infections or malignancies. We describe a case of 1,25-(OH) vitamin D-mediated hypercalcemia in a patient presenting with progressive cognitive decline and weakness. Initial evaluation revealed a new diagnosis of HIV, for which he was started on antiretroviral therapy (ART). Read More

Med Clin (Barc) 2019 Jan 3. Epub 2019 Jan 3.

Servicio de Hematología y Hemoterapia, Hospital Universitario Miguel Servet, Zaragoza, España. Electronic address:

Tumour lysis syndrome (TLS) is a life-threatening emergency characterised by a massive cytolysis with the release of intracellular electrolytes, nucleic acids, and metabolites into the circulation. TLS comprises laboratory derangements (hyperuricaemia, hyperkalaemia, hyperphosphataemia, and hypocalcaemia) responsible for acute kidney injury. In patients with hematologic malignancies after cytotoxic therapy or spontaneously and also in advanced solid tumours. Read More

Respir Med Case Rep 2019 23;26:142-145. Epub 2018 Dec 23.

Pulmonary and Critical Care Medicine, Marshall University School of Medicine, Huntington, WV, USA.

Rasburicase is a recombinant urate-oxidase enzyme and is a very important medication for tumor lysis syndrome. Methemoglobinemia and hemolysis are known side effects of rasburicase that result from oxidative stress caused by hydrogen peroxide, a byproduct generated during the breakdown of uric acid to allantoin. Patients with G6PD deficiency have a decreased tolerance to oxidative stress and are therefore at a greater risk of hemolysis and methemoglobinemia with rasburicase. Read More

J Family Med Prim Care 2018 Sep-Oct;7(5):1116-1119

Department of Pathology, Aster MIMS, Kozhikode, Kerala, India.

Tumor lysis syndrome is an oncological emergency caused by massive tumor lysis resulting in a constellation of metabolic abnormalities. It is observed most frequently in patients with high-grade hematological malignancies undergoing treatment. Tumor lysis syndrome can occur spontaneously and it can present as the first symptom of an underlying malignancy. Read More

Tumori 2018 Dec 23:300891618793817. Epub 2018 Dec 23.

1 Department of Hematology, Kocaeli University School of Medicine, Kocaeli, Turkey.

Background:: Tumor lysis syndrome (TLS) is a potentially fatal complication of cancer therapy characterized by severe electrolyte and metabolic abnormalities such as hyperphosphatemia, hyperkalemia, and hypocalcaemia. TLS usually occurs in aggressive hematologic malignancies such as Burkitt lymphoma and acute leukemia. TLS has rarely been observed in multiple myeloma (MM). Read More

BMJ Case Rep 2018 Dec 19;11(1). Epub 2018 Dec 19.

Department of Hematology and Oncology, University of Florida, Gainesville, Florida, USA.

A middle-aged woman with a history of leiomyosarcoma of the uterus treated with surgery and adjuvant chemotherapy suffered a bulky metastatic recurrence 1 year later. She elected treatment with palliative eribulin, presenting with acute renal failure and electrolyte abnormalities consistent with tumour lysis syndrome on cycle 1 day 8. Despite aggressive supportive care and treatment including intravenous hydration, bicarbonate and rasburicase, she continued to decline, ultimately foregoing haemodialysis in favour of palliative care and passed away in the hospital. Read More

BMJ Case Rep 2018 Nov 28;11(1). Epub 2018 Nov 28.

Internal Medicine, Riverside Methodist Hospital, Columbus, Ohio, USA.

Tumour lysis syndrome (TLS) is a life-threatening complication wherein massive tumour cell lysis results in severe metabolic abnormalities. TLS generally follows chemotherapy of rapidly proliferating haematological malignancies; spontaneous TLS and TLS from treatment of solid tumours are infrequently reported. We present a rare case of TLS following treatment of a large gastrointestinal stromal tumour (GIST) in a 63- year-old man. Read More

Blood Adv 2018 Dec;2(24):3566-3571

Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.

Early data on venetoclax-containing regimens for the treatment of chronic lymphocytic leukemia (CLL) show promising results with deep remissions, but are hampered by potential risk for tumor lysis syndrome (TLS). Whether optimal duration of venetoclax treatment can be guided by minimal residual disease (MRD) is currently unknown. To study whether TLS risk can be mitigated in an unfit population by introducing preinduction, and whether MRD-guided duration of venetoclax treatment is a feasible and efficacious approach, we performed the Dutch-Belgian Cooperative Trial Group for Hemato-oncology (HOVON) 139/GIVE trial. Read More

Arch Pathol Lab Med 2018 Nov 30. Epub 2018 Nov 30.

From the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.

Tumor lysis syndrome (TLS) is an acute, life-threatening disease among adults and children that is associated with the initiation of cytoreductive therapy in the treatment of malignancy. A pattern of metabolic derangements occurs as a result of a massive release of intracellular contents into the systemic circulation. Characteristic findings include hyperuricemia, hyperphosphatemia, hyperkalemia, hypocalcemia, and uremia, all of which can lead to cardiac arrhythmia, seizures, renal failure, and sudden death. Read More

J Nucl Med 2018 Nov 21. Epub 2018 Nov 21.

Uniklinik Ulm, Germany.

Radioligand therapy (RLT) is considered a safe treatment for patients with metastasized neuroendocrine tumors (NET) and prostate cancer (PC), and the occurrence of tumor lysis syndrome (TLS) with Lutetium (Lu)-labeled peptides has not been reported so far. We retrospectively screened our patients' database for TLS after RLT in NET and PC. The database was searched for patients receiving RLT with Lu-DOTATATE, -DOTATOC or -PSMA and showing laboratory or clinical abnormalities typical for TLS within 7 days after start of treatment. Read More

J Intensive Care Med 2018 Nov 9:885066618803863. Epub 2018 Nov 9.

1 Critical Care Medicine Service, Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Cancer continues to be a leading cause of death despite a broader understanding of its biology and the development of novel therapies. Nonetheless, with an increasing survival of this population, intensivists must be aware of the associated emergencies, both old and new. Oncologic emergencies can be seen as an initial presentation of the disease or precipitated by its treatment. Read More

Invest New Drugs 2018 Nov 9. Epub 2018 Nov 9.

Clinical Research Unit, Institut Claudius Regaud, IUCT- Oncopole, 1 avenue Joliot-Curie, Toulouse, 31059, France.

Background Plocabulin (PM060184) is a novel marine-derived microtubule inhibitor that acts as an antitumor agent. This first-in-human study evaluated dose-limiting toxicities (DLT) to define the maximum tolerated dose (MTD) and phase II recommended dose (RD) of plocabulin given as a 10-min infusion on Day (D) 1, D8 and D15 every four weeks. Patients and methods Forty-four patients with advanced solid tumors received plocabulin following an accelerated titration design. Read More

J Pak Med Assoc 2018 Nov;68(11):1625-1630

Indus Hospital Research Center, The Indus Hospital, Karachi-Pakistan.

Objective: To determine the incidence of tumour lysis syndrome and to identify associated factors and mortality rate in paediatric haematological patients.

Methods: The prospective study was conducted from April to September 2016 at Indus Children Cancer Hospital, Karachi, and collected data for all new paediatric oncology patients registered with diagnosis of haematological malignancies. Each patient was monitored for a period of three days before and seven days after the start of the treatment. Read More

Indian J Hematol Blood Transfus 2018 Oct 3;34(4):618-622. Epub 2018 Mar 3.

Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamilnadu India.

Rasburicase is a recombinant urate oxidase enzyme approved for use in tumor lysis syndrome (TLS) and it acts by reducing serum uric acid levels. Using rasburicase at the recommended dose of 0.2 mg/kg/day for 5 days is expensive and it is not known whether this extended schedule is clinically beneficial compared to a single fixed dose of 1. Read More

Blood 2019 Jan 25;133(1):7-17. Epub 2018 Oct 25.

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.

Older patients with acute myeloid leukemia (AML) respond poorly to standard induction therapy. B-cell lymphoma 2 (BCL-2) overexpression is implicated in survival of AML cells and treatment resistance. We report safety and efficacy of venetoclax with decitabine or azacitidine from a large, multicenter, phase 1b dose-escalation and expansion study. Read More

J Clin Oncol 2018 Oct 25:JCO1800359. Epub 2018 Oct 25.

Matthew S. Davids, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Gottfried von Keudell, Yale School of Medicine, New Haven, CT; Craig A. Portell, University of Virginia Health System, Charlottesville, VA; Jonathon B. Cohen, Winship Cancer Institute of Emory University, Atlanta, GA; David C. Fisher, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Francine Foss, Yale School of Medicine, New Haven, CT; Andrew W. Roberts, Royal Melbourne Hospital and University of Melbourne, Melbourne, Victoria, Australia; John F. Seymour, Royal Melbourne Hospital, Peter MacCallum Cancer Centre, and University of Melbourne, Melbourne, Victoria, Australia; Rod A. Humerickhouse, AbbVie, Chicago, IL; and Constantine S. Tam, Royal Melbourne Hospital, Peter MacCallum Cancer Centre, St Vincent's Hospital, and University of Melbourne, Melbourne, Victoria, Australia.

Cancer Chemother Pharmacol 2018 Dec 22;82(6):979-986. Epub 2018 Oct 22.

Institut Universitaire du Cancer de Toulouse, Oncopôle, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France.

Background: Trastuzumab is the mainstay of therapy for patients with HER2-positive breast and gastric cancer but resistance frequently occurs. Afatinib, an irreversible oral ErbB family blocker, shows clinical activity in trastuzumab-refractory HER2-positive metastatic breast cancer.

Materials And Methods: This phase I study used a modified 3 + 3 dose escalation design to determine the maximum tolerated dose (MTD) of oral once-daily afatinib in combination with 3-weekly intravenous trastuzumab (8 mg/kg week 1; 6 mg/kg 3-weekly thereafter) for patients with confirmed advanced or metastatic HER2-positive cancer. Read More

J Adv Pract Oncol 2017 Nov-Dec;8(7):705-720. Epub 2017 Nov 1.

University of Memphis, School of Health Studies, Memphis, Tennessee.

Tumor lysis syndrome (TLS) is a potentially life-threatening emergency that can develop rapidly after the release of intracellular contents from lysed malignant cells. The advent of novel and targeted therapies that have improved tumor-killing efficacy has the potential to increase the risk of TLS when used as part of front-line therapy. A recent review of TLS risk in patients with hematologic malignancies treated with newer targeted agents highlighted the need to revisit TLS risk stratification and to describe the practical challenges of TLS prevention, treatment, and monitoring. Read More

Eur J Immunol 2018 Dec 29;48(12):1975-1988. Epub 2018 Oct 29.

Department of Clinical Microbiology, Karolinska University Hospital, Solna, Sweden.

The autosomal-dominant hyper-IgE syndrome (HIES), caused by mutations in STAT3, is a rare primary immunodeficiency that predisposes to mucocutaneous candidiasis and staphylococcal skin and lung infections. This infection phenotype is suggestive of defects in neutrophils, but data on neutrophil functions in HIES are inconsistent. This study was undertaken to functionally characterize neutrophils in STAT3-deficient HIES patients and to analyze whether the patients` eosinophilia affects the neutrophil phenotype in S. Read More

Blood Res 2018 Sep 28;53(3):223-226. Epub 2018 Sep 28.

Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

Background: Bendamustine is a chemotherapeutic agent that has shown broad activity in patients with lymphoid malignancies. It contains both alkylating and nucleoside analog moieties, and thus, is not commonly used for stem cell mobilization due to concerns that it may adversely affect stem cell collection. Here we describe the lymphoma subset of a prospective, non-randomized phase II study of bendamustine, etoposide, and dexamethasone (BED) as a mobilization agent for lymphoid malignancies. Read More

QJM 2019 Jan;112(1):39-40

Department of Internal Medicine of H.U. Marqués de Valdecilla, Santader, Spain.

Curr Mol Med 2018 ;18(5):335-342

Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.

Antibody-toxin fused agents or immunotoxins, are a newly engineered class of cytotoxic agents consisting of a bacterial or plant toxin moiety hooked up either to a monoclonal antibody or a specific growth factor. Nevertheless, acquiring a full potency in clinic is mostly restricted due to the Capillary leak syndrome (CLS), a serious immune provoked, life-threatening side effect, subsequent to the endothelial damage, resulting in fluid escape from the bloodstream into tissues including lungs, muscle and brain, developing organ failure and eventually death. Proposed underlying mechanisms include direct damage to endothelial cells, acute inflammation, Lymphokine-activated killer (LAK) cells engagement, alteration in cell-cell/cell-matrix connectivities and cytoskeletal dysfunction. Read More

Clin Kidney J 2018 Oct 11;11(5):670-680. Epub 2018 Apr 11.

Division of Kidney Diseases and Hypertension, Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA.

Chronic lymphocytic leukemia (CLL) is the most commonly diagnosed adult leukemia in the USA and Western Europe. Kidney disease can present in patients with CLL as a manifestation of the disease process such as acute kidney injury with infiltration or with a paraneoplastic glomerular disease or as a manifestation of extra renal obstruction and tumor lysis syndrome. In the current era of novel targeted therapies, kidney disease can also present as a complication of treatment. Read More

J Pharm Pract 2018 Oct 2:897190018802129. Epub 2018 Oct 2.

2 Department of Hematology and Oncology, Northwell Health Staten Island University Hospital, Staten Island, NY, USA.

In the area of multiple myeloma (MM) therapy, proteasome inhibitors (PI) have emerged with promising responses both in the first- and second-line setting. Carfilzomib (CFZ) is a second-generation, selective PI approved in 2012 for the treatment of relapsed/refractory multiple myeloma (RRMM) in patients who received 2 prior therapies or have evidence of disease progression within 60 days of completion of last therapy. Its safety profile reported adverse events (AEs) ranging from drug-related AEs (nausea and vomiting), hematologic AEs (neutropenia and thrombocytopenia), and nonhematologic AEs (electrolyte imbalances). Read More

Leuk Lymphoma 2018 Oct 2:1-10. Epub 2018 Oct 2.

a Princess Margaret Cancer Centre , Toronto , ( ON ) Canada.

Lenalidomide has anti-tumor activity in CLL but can be complicated by tumor lysis syndrome (TLS) and tumor flare (TF). In our previous study using low-dose lenalidomide in treatment-naive CLL, TLS was averted but TF remained frequent and complete responses (CR) were rare, despite treatment to progression. The addition of dexamethasone may mitigate TF and enable lenalidomide dose escalation, achieving durable response without long-term use. Read More

Clin Genitourin Cancer 2019 Feb 7;17(1):e61-e64. Epub 2018 Sep 7.

Oncology Center, Hospital Sírio-Libanês, São Paulo, Brazil. Electronic address:

Arab J Gastroenterol 2018 Sep 24;19(3):130-133. Epub 2018 Sep 24.

Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka 411-8777, Japan.

A 25-year-old man, with a retroperitoneal bulky mass invading the posterior pancreas head, was referred to investigate and treat his rapidly advancing disease. An endoscopic ultrasonography guided-fine needle aspiration biopsy (EUS-FNAB), performed the next day, and followed by immunostaining for human chorionic gonadotropin (hCG), led to a histological diagnosis of choriocarcinoma. An elevated level of serum hCG also supported the diagnosis. Read More

J Cancer Res Ther 2018 Sep;14(Supplement):S803-S805

Department of Urology and Andrology, Graduate School of Medicine, Kansai Medical University, Osaka, Japan.

Choriocarcinoma syndrome is a life-threatening lysis syndrome caused by blood vessel rupture and subsequent tumor bleeding. We describe a case of pretreatment choriocarcinoma syndrome that developed in a 27-year-old man. He underwent a high orchiectomy at a local hospital and was diagnosed with metastatic testicular tumor given the high serum human chorionic gonadotropin levels (943,601 mIU/mL). Read More

Clin Lymphoma Myeloma Leuk 2018 Dec 18;18(12):803-813.e7. Epub 2018 Aug 18.

The Leeds Teaching Hospitals, St. James University Hospital, Leeds, United Kingdom.

Background: Ibrutinib compared with ofatumumab significantly improves progression-free and overall survival in patients with previously treated chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).

Patients And Methods: Measures of well-being were assessed in RESONATE, where previously treated patients with CLL/SLL were randomized to receive ibrutinib 420 mg/day (n = 195) or ofatumumab (n = 196) for up to 24 weeks. Endpoints included hematologic function, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), disease-related symptoms, European Organization for Research and Treatment of Cancer Quality of Life Questionnaires Core 30 (EORTC QLQ-C30), and medical resource utilization. Read More

J Glob Oncol 2018 Sep 8(4):1-4. Epub 2017 Feb 8.

All authors: University of Arkansas for Medical Sciences, Little Rock, AR.

J Adolesc Young Adult Oncol 2018 Oct 21;7(5):546-552. Epub 2018 Sep 21.

5 Division of Hematology, University of Southern California , Los Angeles, California.

Purpose: A study of vincristine sulfate (VCR) liposome injection (VSLI) was conducted in patients with advanced, relapsed, or refractory, Philadelphia chromosome-negative acute lymphoblastic/lymphocytic leukemia (ALL). A retrospective subgroup analysis of the results was performed to evaluate the safety and efficacy of VSLI in the adolescent and young adult (AYA) patients.

Methods: Of the 65 patients treated in the pivotal Phase 2 Study HBS407 (NCT00495079), 44 patients were aged ≤39 years (median 27 [range 19-39] years) and were included in this analysis. Read More

3 Biotech 2018 Sep 7;8(9):400. Epub 2018 Sep 7.

2School of Life Science, University of Science and Technology of China, No. 96 Jinzhai Road, Hefei, 230036 Anhui China.

Uricase as an important healthcare-related protein is extensively used in the treatment of tumor lysis syndrome and in the manufacture of serum uric-acid diagnostic kits. In this study, a gene of a new thermostable uricase (KmUOX) was cloned from thermotolerant yeast . The uricase was fused with a self-cleaving intein and cellulose-binding affinity tag and expressed in BL21 (DE3). Read More

Ann Thorac Surg 2018 Sep 12. Epub 2018 Sep 12.

Department of Surgery, Division of Thoracic Surgery. Electronic address:

Tumor lysis syndrome (TLS) is a life-threatening complication comprised of hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia attributed to release of intracellular contents. While traditionally associated with leukemia and lymphoma after chemotherapy, it is known to occur in solid malignancies. We herein report a rare case of this syndrome after resection of bulky carcinoid tumor of the lung. Read More

Ann Hematol 2018 Sep 14. Epub 2018 Sep 14.

Medical Intensive Care Unit, AP-HP, Saint-Louis University Hospital, 1 avenue Claude Vellefaux, 75010, Paris, France.

T cell non-Hodgkin lymphomas (T-NHLs) are aggressive malignancies which have a high risk of life-threatening complications. However, their prognosis in the intensive care unit (ICU) setting has not yet been assessed. We conducted a study including 87 ICU patients either with newly diagnosed T-NHLs or those undergoing first-line therapy admitted between January 1, 2000, and December 31, 2014. Read More

Am Fam Physician 2018 Jun;97(11):741-748

Novant health Family Medicine Residency, Charlotte, NC, USA.

Most oncologic emergencies can be classified as metabolic, hematologic, structural, or treatment related. Tumor lysis syndrome is a metabolic emergency that presents as severe electrolyte abnormalities. Stabilization is focused on vigorous rehydration, maintaining urine output, and lowering uric acid levels. Read More

N Engl J Med 2018 Sep 13;379(11):1094. Epub 2018 Sep 13.

BMC Hematol 2018 4;18:22. Epub 2018 Sep 4.

2Department of Medical Biochemistry, School of Medicine, College of Health sciences, Addis Ababa University, P. O. Box 9086, Addis Ababa, Ethiopia.

Background: Tumor lysis syndrome (TLS) is a life-threatening emergency disorder, caused by an abrupt release of intracellular metabolites after tumor cell death. It is characterized by a series of metabolic manifestations, especially hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. The aim of this study was to evaluate and characterize the incidence of tumor lysis syndrome among pediatric oncology patients before and after treatment. Read More

BMJ Case Rep 2018 Aug 27;2018. Epub 2018 Aug 27.

Oncoanaesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Use of strong opioids like morphine as analgesics for painful conditions in haematological malignancies is a challenging task. We report a unique case of chronic myelomonocytic leukaemia presenting with opioid toxicity overlapping with tumour lysis syndrome. The patient was on hydroxyurea-based chemotherapy for the primary disease. Read More

Haematologica 2019 Jan 16;104(1):147-154. Epub 2018 Aug 16.

Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht.

Lenalidomide has been proven to be effective but with a distinct and difficult to manage toxicity profile in the context of chronic lymphocytic leukemia, potentially hampering combination treatment with this drug. We conducted a phase 1-2 study to evaluate the efficacy and safety of six cycles of chlorambucil (7 mg/m daily), rituximab (375 mg/m cycle 1 and 500 mg/m cycles 2-6) and individually-dosed lenalidomide (escalated from 2.5 mg to 10 mg) (induction-I) in first-line treatment of patients with chronic lymphocytic leukemia unfit for treatment with fludarabine, cyclophosphamide and rituximab. Read More

Blood 2018 Oct 15;132(15):1568-1572. Epub 2018 Aug 15.

Division of Hematology.

Targeted therapies including the engineered afucosylated anti-CD20 monoclonal antibody obinutuzumab, Bruton's tyrosine kinase inhibitor ibrutinib, and B-cell lymphoma protein 2 inhibitor venetoclax have demonstrated significant clinical activity in chronic lymphocytic leukemia (CLL) and, based on their complementary mechanisms, are ideal for combination. However, combining venetoclax with other active agents raises safety concerns, as it may increase the risk for tumor lysis syndrome. To minimize this risk, we designed and implemented a fixed-duration regimen using sequentially administered obinutuzumab followed by ibrutinib (cycle 2) and venetoclax (cycle 3), for a total of fourteen 28-day cycles. Read More

J Oncol Pharm Pract 2018 Aug 15:1078155218791333. Epub 2018 Aug 15.

1 Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA, USA.

Background Tumor lysis syndrome is an oncologic emergency due to the release of tumor cell contents, leading to metabolic derangements. Rasburicase, a recombinant urate oxidase, catabolizes uric acid. At our institution, we administer a single 6-mg dose of rasburicase to patients who are at risk for tumor lysis syndrome. Read More

Pediatr Blood Cancer 2018 Dec 12;65(12):e27401. Epub 2018 Aug 12.

Department of Pediatric Oncology, Regional Cancer Centre, Trivandrum, Kerala, India.

Background: Data from low- and middle-income countries on tumor lysis syndrome (TLS) in the pediatric population are limited. This study aims to analyze the clinical and biochemical characteristics and treatment outcomes of TLS in children with leukemia/lymphomas in a resource-limited setting.

Procedure: Children with intermediate risk (IRD) and high risk (HRD) for developing TLS were retrospectively studied at a tertiary cancer center in India. Read More