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Acute Tumor Lysis Syndrome in Burkitt Lymphoma.

Journal of the Korean Pediatric Society 1988;31(3):362-369.
Published online March 31, 1988.
Acute Tumor Lysis Syndrome in Burkitt Lymphoma.
Dong Kyu Jin, Soo Jong Hong, Il Soo Ha, Hyo Seop Ahn, Yong Choi, Chang Yee Hong
Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
Burkitt 림프종에서 발생한 급성 종양 융해증후군
진동규, 홍수종, 하일수, 안효섭, 최용, 홍창의
서울대학교 의과대학 소아과학교실
Received: 17 September 1987
To assess the tumor lysis syndrome in Burkitt lymphoma, we analyzed the clinical and laboratory findings of 17 patients with Burkitt lymphoma who were admitted to the Department of Pediatrics, Seoul National University Hospital from January 1979 to December 1986. The acute tumor lysis syndrome was diagnosed when two of the five following metabolic abnormal- ities were met: ① hyperuricemia (≥8.0mg/dl), ② hyperphosphatemia (≥5.5 mg/dl), ③ hypocalcemia (total cal- cium ≤6.0 mg/dl), ④ hyperkalemia (≥5.5 mEq/1), ⑤ elevated creatinine (≥1.5 mg/dl). The results obtained were as follows; 1) Two cases showed acute tumor lysis syndrome before chemotherapy and 6 cases after chemo- therapy. 2) The number of the patients in each stage was as follows: two in stage A, two in stage AR, one in stage C and twelve in stage D. The acute tumor lysis syndrome was observed in one of the stage C and seven of the stage D patients. 3) Elevated creatinine was seen in 2 cases and acute renal failure in 1 before chemotherapy. 4) Acute tumor lysis syndrome was seen in 7 of 9 cases of hyperuricemia and 5 of 7 cases of elevated LDH. So, hyperuricemia was a statistically more significant index than LDH in our study (p< 0.05). 5) Of the 6 cases who developed postchemotherapy tumor lysis syndrome, 5 cases showed hyper- phosphatemia which was accompanied by hypocalcemia (r= —0.82). Peak uric acid level was well correlated with peak creatinine(r=0.94). 6) In management of the Burkitt lymphoma patients, supportive therapy, including renal replace- ment therapy, is of vital importance as well as eradication of the tumor.
Key Words: Burkitt lymphoma, Acute tumor lysis syndrome, Uric acid

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