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Am J Case Rep 2021 Jun 14;22:e932081. Epub 2021 Jun 14.

Department of Hematology-Oncology, Alabama Oncology Hematology Associates, Montgomery, AL, USA.

BACKGROUND Lurbinectedin (Lurbi) was first approved in June 2020 for metastatic small cell lung cancer (SCLC) patients with progression following platinum-based chemotherapy. Extrapulmonary small cell neuroendocrine cancers (SCNECs) are treated with regimens used for SCLCs. Tumor lysis syndrome (TLS) in solid SCLCs and SCNECs following Lurbi use has not been reported in the literature so far. Read More

J Oncol Pharm Pract 2021 Jun 11:10781552211021147. Epub 2021 Jun 11.

Department of Pharmacy, Albany Medical Center Hospital, Albany, NY, USA.

Introduction: Tumor lysis syndrome is an oncologic emergency characterized by hyperuricemia. Previous studies have demonstrated that a fixed-dose strategy of rasburicase is as effective as the FDA approved weight-based dose. Albany Medical Center employs rasburicase 1. Read More

Am J Hematol 2021 Jun 11. Epub 2021 Jun 11.

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester.

Introduction: Multiple myeloma (MM) remains an incurable disease despite incorporation of novel agents. Venetoclax, a B-cell lymphoma 2 (BCL-2) inhibitor is approved for some hematologic malignancies but not yet for MM, although clinical trials have shown efficacy in patients with MM particularly those harboring t(11;14).

Methods: We reviewed the medical records of relapsed and/or refractory MM patients to study the efficacy and safety of venetoclax used outside of clinical trials at Mayo Clinic between December 2016 and March 2019. Read More

Leuk Res Rep 2021 19;15:100246. Epub 2021 May 19.

Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.

Introduction: Renal infiltration by leukemia causing massive bilateral nephromegaly is an extremely rare presentation of T-cell acute lymphoblastic leukemia(T-ALL).

Case Report: 18-month-old female toddler presented with fever and progressive abdominal distension of 4-6 weeks duration. Imaging revealed bilateral massively enlarged kidneys with normal excretion. Read More

Rinsho Ketsueki 2021 ;62(5):346-351

Department of Hematology/Oncology, Saitama Children's Medical Center.

A 14-year-old male with autism was admitted to our hospital owing to altered consciousness and gait disturbance. Blood tests showed a white blood cell (WBC) count of 728,600/µl, and brain computed tomography revealed intracranial hemorrhage and a midline shift of the brain. The chronic phase of chronic myeloid leukemia (CML) was confirmed as per bone marrow aspiration findings. Read More

Cureus 2021 Jun 2;13(6):e15392. Epub 2021 Jun 2.

Emergency Medicine, Brandon Regional Hospital, Brandon, USA.

Acute myeloid leukemia (AML) and other hematologic malignancies can be complicated by hyperleukocytosis, which leads to an increased risk for other severe complications such as tumor lysis syndrome, disseminated intravascular coagulation (DIC), and leukostasis. In this report, we present a case of a 65-year-old female with newly diagnosed AML complicated by leukostasis. We briefly review the clinical significance as well as initial diagnostic and therapeutic considerations pertaining to hyperleukocytosis and its associated complications. Read More

J Pediatr Hematol Oncol 2021 May 31. Epub 2021 May 31.

Department of Pediatrics, Division of Pediatric Hematology, Kocaeli University, Kocaeli, Turkey.

Indications of leukapheresis (LPh) and the prophylactic use of rasburicase in tumor lysis syndrome (TLS) of patients with acute leukemia with hyperleukocytosis are not clear. In this retrospective single-center pediatric study, the outcomes of patients with hyperleukocytosis were reviewed. There were 48 patients with acute lymphoblastic leukemia (ALL) and 13 patients with acute myeloblastic leukemia (AML). Read More

Clin Cancer Res 2021 May 27. Epub 2021 May 27.

Office of Hematology and Oncology, Food and Drug Administration.

The FDA granted accelerated approval for pralsetinib on September 4 for NSCLC and December 1, 2020 for thyroid cancer, for: 1) adult patients with metastatic fusion-positive non-small cell lung cancer (NSCLC), 2) adult and pediatric patients {greater than or equal to}12 years of age with advanced or metastatic -mutant medullary thyroid cancer (MTC) who require systemic therapy, and 3) adult and pediatric patients {greater than or equal to}12 years of age with advanced or metastatic fusion-positive thyroid cancer who require systemic therapy and who are radioactive iodine-refractory (if radioactive iodine is appropriate). Approval was based on the results of a multicenter, open-label, multi-cohort clinical trial (ARROW, NCT03037385), demonstrating substantial overall response rates (ORR) and durable responses in patients with altered tumors. ORRs within the approved patient populations ranged from 57% (95% CI: 46, 68) in patients with fusion-positive NSCLC previously treated with platinum chemotherapy to 89% (95% CI: 52, 100) in patients with fusion-positive thyroid cancer, with response duration of at least 6 months in most responders. Read More

Curr Med Res Opin 2021 Jun 7:1-12. Epub 2021 Jun 7.

Janssen Scientific Affairs, LLC, Horsham, PA, USA.

Objective: This study aimed to describe treatment sequencing and healthcare costs among chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) patients treated with venetoclax in a US managed care population.

Methods: CLL/SLL patients initiating venetoclax between 04/11/2016 and 06/30/2019 were selected from Optum's de-identified Clinformatics Data Mart Database. Costs per-patient-per-month were described during the first 60 days of venetoclax-based treatment (initiation phase) and subsequent post-initiation phase. Read More

Front Immunol 2021 28;12:663201. Epub 2021 Apr 28.

Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.

The application of chimeric antigen receptor (CAR) T-cell therapy as a tumor immunotherapy has received great interest in recent years. This therapeutic approach has been used to treat hematological malignancies solid tumors. However, it is associated with adverse reactions such as, cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), off-target effects, anaphylaxis, infections associated with CAR-T-cell infusion (CTI), tumor lysis syndrome (TLS), B-cell dysplasia, hemophagocytic lymphohistiocytosis (HLH)/macrophage activation syndrome (MAS) and coagulation disorders. Read More

J Dermatol 2021 May 14. Epub 2021 May 14.

Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan.

Cureus 2021 Apr 10;13(4):e14406. Epub 2021 Apr 10.

Internal Medicine, Creighton University School of Medicine, Omaha, USA.

Methemoglobinemia occurs as iron in heme is oxidized to its ferric state, resulting in a decreased ability of hemoglobin to bind and release oxygen. Rasburicase is a recombinant urate-oxidase enzyme used in the prevention of tumor lysis syndrome. Methemoglobinemia can occur as a rare complication of treatment with rasburicase, primarily in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Read More

Sci Rep 2021 May 6;11(1):9656. Epub 2021 May 6.

Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.

Tumor lysis syndrome (TLS) is a common and fatal complication of childhood hematologic malignancies, especially acute lymphoblastic leukemia (ALL). The clinical features, therapeutic regimens, and outcomes of TLS have not been comprehensively analyzed in Chinese children with ALL. A total of 5537 children with ALL were recruited from the Chinese Children's Cancer Group, including 79 diagnosed with TLS. Read More

Leuk Res 2021 Apr 24;107:106588. Epub 2021 Apr 24.

Section of Leukemia, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.

Background: Rasburicase can markedly and rapidly decrease uric acid (UA) levels, thereby preventing and treating tumor lysis syndrome. However, rasburicase is expensive, especially when used as per the manufacturer's recommended dosage of 0.2 mg/kg/day for up to 5 days. Read More

Breast Cancer (Auckl) 2021 12;15:11782234211006677. Epub 2021 Apr 12.

Oncology Department, Rotorua Hospital, Rotorua, New Zealand.

Tumour lysis syndrome (TLS) is a medical emergency occurring when large numbers of cancer cells rapidly undergo cell death. The resultant metabolic abnormalities results in significant morbidity and mortality. Tumour lysis syndrome most commonly occurs in 5% of haematological malignancies and is less commonly described in solid organ cancers. Read More

CEN Case Rep 2021 Apr 28. Epub 2021 Apr 28.

Department of Nephrology, Japan Community Health Care Organization Sendai Hospital, 3-16-1, Tsutsumimachi, Aoba-Ku, Sendai, Miyagi, 981-8501, Japan.

A 75-year-old man admitted with IgG λ-type myeloma with creatinine level of 2.3 mg/dL. Serum lactate dehydrogenase level and platelet count were normal. Read More

Clin Nephrol Case Stud 2021 16;9:39-44. Epub 2021 Apr 16.

Medicine Service, Ralph H. Johnson VA Medical Center, Charleston, and.

Burkitt's lymphoma is a common cause of tumor lysis syndrome (TLS) and, in the era of aggressive utilization of prophylactic allopurinol and recombinant uricase enzyme, nephrologists are increasingly witnessing monovalent or divalent cation abnormalities without marked uric acid elevation. An 18-year-old male received his 1 cycle of intensive chemotherapy for Burkitt's lymphoma and developed TLS as defined by the Cairo Bishop criteria. Lactate dehydrogenase peaked at 9,105 U/L (range: 130 - 250) and was accompanied by acute kidney injury, including serum creatinine 2. Read More

Cureus 2021 Mar 11;13(3):e13816. Epub 2021 Mar 11.

Center for Personalized Cancer Therapy, University of California San Diego Moores Cancer Center, La Jolla, USA.

Tumor lysis syndrome, an oncological emergency, is characterized by laboratory parameters such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, as well as renal injury with an elevated creatinine. Tumor lysis syndrome is seen in patients with aggressive malignancies and high tumor burden. More frequently, it occurs in individuals with hematologic malignancies such as high-grade lymphomas (such as Burkitt lymphoma) and leukemia (such as acute lymphocytic leukemia). Read More

Iran J Biotechnol 2020 Jul 1;18(3):e2662. Epub 2020 Jul 1.

Department of Medical Biotechnology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background And Purpose: As a therapeutic enzyme, urate oxidase is utilized in the reduction of uric acid in various conditions such as gout or tumor syndrome lysis. However, even bearing kinetical advantage over other counterparts, it suffers from structural instability most likely due to its subcellular and fungal origin.

Objectives: In this research, by using rational design and introduction of disulfide bridge in urate oxidase structure, we designed and created a thermostable urate oxidase for the first time. Read More

Cureus 2021 Mar 8;13(3):e13758. Epub 2021 Mar 8.

Anesthesiology, University of Florida, Gainesville, USA.

Episodic hyperkalemia has not been described during resection of a primary thymoma tumor. We present a case of significant intraoperative hyperkalemia during a technically challenging resection of a type B-1 thymoma. The hyperkalemia, presumed to be secondary to considerable tumor manipulation, was successfully controlled with calcium, bicarbonate, and insulin with dextrose. Read More

Am J Hematol 2021 07 29;96(7):790-795. Epub 2021 Apr 29.

Department of Hematology, Shamir Medical Center (formerly Assaf Harofe Medical Center), Zerifin, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Combinations of the BCL-2 inhibitor, venetoclax, with either hypomethylating agents (HMA) or low dose cytarabine (LDAC), have shown promising results in clinical trials of AML patients unfit for intensive therapy. We report on the efficacy and safety of venetoclax combinations in AML patients treated outside of clinical trials. Complete remission (CR) + CR with incomplete count recovery (CRi) were achieved in 61% of patients, with similar CR+CRi rates in with secondary AML, and in patients who were previously treated with HMA (61% and 43%, respectively). Read More

MAbs 2021 Jan-Dec;13(1):1890411

Teneobio, Inc., Newark, CA, United States.

The therapeutic potential of targeting CD19 in B cell malignancies has garnered attention in the past decade, resulting in the introduction of novel immunotherapy agents. Encouraging clinical data have been reported for T cell-based targeting agents, such as anti-CD19/CD3 bispecific T-cell engager blinatumomab and chimeric antigen receptor (CAR)-T therapies, for acute lymphoblastic leukemia and B cell non-Hodgkin lymphoma (B-NHL). However, clinical use of both blinatumomab and CAR-T therapies has been limited due to unfavorable pharmacokinetics (PK), significant toxicity associated with cytokine release syndrome and neurotoxicity, and manufacturing challenges. Read More

Diagnostics (Basel) 2021 Mar 29;11(4). Epub 2021 Mar 29.

Division of Nephrology & Kidney Clinical Advancement, Research & Education Program, University of Cincinnati, Cincinnati, OH 45267, USA.

Over the last three decades, advancements in the diagnosis, treatment, and supportive care of patients with cancer have significantly improved their overall survival. However, these advancements have also led to a higher rate of cancer-related complications. Acute kidney injury (AKI) and chronic kidney disease (CKD) are highly prevalent in patients with cancer, and they are associated with an increased risk of all-cause mortality. Read More

J Pediatr Hematol Oncol 2021 Mar 31. Epub 2021 Mar 31.

Departments of Pediatric Intensive Care Pediatric Hematology and Oncology Radiology Neurosurgery, Istanbul Faculty of Medicine Istanbul Faculty of Medicine Child Health Institute, Istanbul University, Istanbul, Turkey.

Acute leukemia in children may present with hyperleukocytosis. Symptomatic hyperleukocytosis is a medical emergency that necessitates rapid stabilization of the patient and prompt lowering of the leukocyte count. We report on a patient with intracranial hemorrhage associated with T-cell acute lymphoblastic leukemia with hyperleukocytosis, which is a rare occurrence. Read More

Exp Ther Med 2021 May 16;21(5):484. Epub 2021 Mar 16.

Institute of Tissue Engineering and Stem Cells, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China.

Chimeric antigen receptor (CAR)-modified T-cells are T-cells that have been genetically engineered to express CAR molecules to target specific surface antigens on tumor cells. CAR T-cell therapy, a novel cancer immunotherapy, has been attracting increasing attention, since it exhibited notable efficacy in the treatment of hematological tumors in clinical trials. However, for this type of therapy, challenges must be overcome in the treatment of solid tumors. Read More

Transl Oncol 2021 Jun 28;14(6):101070. Epub 2021 Mar 28.

Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Science, Tehran, Iran; Breast Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Cell-based immunotherapies have been selected for the front-line cancer treatment approaches. Among them, CAR-T cells have shown extraordinary effects in hematologic diseases including chemotherapy-resistant acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), and non-Hodgkin lymphoma (NHL). In this approach, autologous T cells isolated from the patient's body genetically engineered to express a tumor specific synthetic receptor against a tumor antigen, then these cells expanded ex vivo and re-infusion back to the patient body. Read More

Crit Care Clin 2021 Apr 13;37(2):365-384. Epub 2021 Feb 13.

Division of Renal Diseases and Hypertension, Department of Internal Medicine, University of Texas Health Science Center at Houston-McGovern Medical School, 6431 Fannin Street, MSB 5.134, Houston, TX 77030, USA.

Current advances in cancer chemotherapeutics have remarkably helped in rapid and definitive treatment options. However, these potent chemotherapeutics have been associated with severe renal toxicities that later impact treatment options. Acute kidney injury is common in patients with cancer. Read More

Semin Oncol Nurs 2021 Apr 17;37(2):151136. Epub 2021 Mar 17.

Emory University Hospital, Brookhaven, GA.

Objectives: To provide an overview of tumor lysis syndrome, which is one of the metabolic oncologic emergencies.

Data Sources: A review and synthesis of empirical articles.

Conclusion: One of the metabolic oncologic emergencies identified by the Oncology Nursing Society is tumor lysis syndrome. Read More

Cureus 2021 Feb 12;13(2):e13299. Epub 2021 Feb 12.

Internal Medicine, Unidade Local de Saúde do Alto Minho (ULSAM), Viana do Castelo, PRT.

T-cell prolymphocytic leukemia (T-PLL) is a very rare and aggressive lymphoproliferative disorder. We present a 70-year-old man with complaints of fatigue, low urinary output, and peripheral edema for one month. Objectively, he presented diminished respiratory sounds bilaterally and peripheral edema. Read More

BMJ Case Rep 2021 Mar 16;14(3). Epub 2021 Mar 16.

Department of Hematology and Oncology, William Beaumont Hospital, Royal Oak, Michigan, USA

We report a case of a 91-year-old Caucasian woman with a history of chronic lymphocytic leukaemia who developed acute hypoxic respiratory failure (AHRF) requiring intubation for less than 24 hours after receiving rasburicase. Laboratory workup was significant for methemoglobinemia and acute anaemia, and blood film demonstrated evidence of oxidative haemolysis with bite cells. The patient was given a presumptive diagnosis of glucose-6-phosphate dehydrogenase (G6PD) deficiency and was managed conservatively with successful resolution of AHRF and stabilisation of haemoglobin level. Read More