Association of Biochemical Derangements with Tumor Lysis Syndrome in Common Haematological Malignancies

Abstract

Objective: To evaluate the frequency of Tumor lysis syndrome (TLS) in patients with common hematological malignancies after first course of chemotherapy and to determine the association of different biochemical derangements in making the diagnosis of TLS.
Methods: Cohort study was conducted in INMOL from October 2012 to October 2013. All patients newly diagnosed with hematological malignancies were included. Blood samples were taken for different biochemical tests (uric acid, potassium, phosphorous, calcium, and creatinine). On the day of admission
base line samples for these parameters labeled as day zero and further samples were taken for 5 consecutive days after induction chemotherapy labeled as day1,2,3,4,5.Cairo bishop criteria were used, according to which two or more above biochemical derangements should be present for making diagnosis
of TLS
Results: Only one patient with AML fulfilled the criteria for TLS and 23 patients with different hematological malignancies at different ages showed different type of biochemical derangements. Statistically significant difference (p<0.05) found in uric acid levels between (D0 vs D1,D0 vs D2, D0 vs D3, D0 vs D4 and D0 vs D5) when compared before and after chemotherapy. Regarding other parameters PO4, K, Ca and Cr did not showed any significant difference (p>0.05).
Conclusion: There was an association of biochemical derangements with TLS in making the diagnosis by using the Cairo bishop criteria as a diagnostic tool and prompt diagnosis of TLS with the help of these biochemical derangements will help to reduce the mortality and morbidity in malignant patients, after
chemotherapy. Prophylactic therapy had a strong impact on patient outcome, decreasing the frequency of
TLS.