Incidence, Risk Factors, and Outcome of Tumor Lysis Syndrome in Hospitalized Children (1–12 Years) with Malignancy

Abstract

Introduction Oncological emergencies such as tumor lysis syndrome (TLS) can strike before or during the start of chemotherapy. TLS is an important cause of death in children with malignancies. Understanding the risk factors and timely management can prevent mortality in these children.

Objectives We performed this study to determine the incidence and risk factors for TLS in hospitalized children (1–12 years old) with malignancy and assess the outcomes in terms of the need for renal replacement therapy, residual kidney dysfunction, and death.

Materials and Methods A prospective observational cohort study was performed for 18 months, and newly diagnosed children with malignancy aged 1 to 12 years with TLS were enrolled. They were followed to assess risk factors for TLS and their outcome.

Results TLS was strongly correlated to the white blood cell count and spleen size at presentation. Uric acid was the most common parameter affected. Most patients developed TLS on day 1 of chemotherapy initiation.

Conclusion Total leucocyte count (≥50,000 mm³) and spleen size more than 3 cm below the costal margin are associated with a higher risk of developing TLS and can be closely followed up for the development of TLS. The use of rasburicase lowers the incidence of TLS and the complications associated with raised uric acid levels.

Keywords

tumor lysis syndrome - oncological - emergency - leukemia - malignancy

Patient Consent

Informed consent was obtained from each patient.

Authors' Contributions

Each author has contributed equally to the preparation of the manuscript. The concept and design of the manuscript were done by S.S. and A.S., the literature search was done by V.K., N.G., and S.S. Data acquisition was done by V.K. and A.S. Data analysis and statistical analysis were done by V.K., S.S., and A.S. Manuscript preparation and manuscript editing were done by V.K., N.G., R.D., and N.G.

Publikationsverlauf

Artikel online veröffentlicht:
14. Februar 2025

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