Retrospective Survey of Tumor Lysis Syndrome and Acute Uric Acid Nephropathy Associated with Cancer Chemotherapy.

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  • Oiwa Kana
    福井大学医学部 血液・腫瘍内科 北陸造血器腫瘍研究会
  • Yamauchi Takahiro
    福井大学医学部 血液・腫瘍内科 北陸造血器腫瘍研究会
  • Hosoya Tatsuo
    東京慈恵会医科大学 腎臓・高血圧内科
  • Ueda Takanori
    福井大学医学部 血液・腫瘍内科 北陸造血器腫瘍研究会

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  • がん化学療法に伴う腫瘍崩壊症候群と急性尿酸性腎症に関する後方視的アンケート調査研究

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Tumor lysis syndrome (TLS) is a life-threatening oncological emergency caused by the rapid release of intracellular materials from lysing malignant cells. The outcomes of novel cancer chemotherapies have recently improved. However, their potent anticancer effects have increased the risk of developing TLS with hyperuricemia and/or renal dysfunction. Several new antihyperuricemic agents have also been developed. The present TLS guidance was published in Japan in 2013, but this may not provide optimal management strategies for TLS. We aimed to determine the present status of TLS and acute uric acid nephropathy (UAN) management in daily clinical practice by conducting a questionnaire survey involving 55 doctors in the Hokuriku Hematology Oncology Study Group. Thirty-eight (69%) respondents described their experiences with 612 patients, among whom 286, 167, and 48 were at low, intermediate, and high risk of TLS, respectively. The responses showed that 13 of the 612 patients who were treated with new anticancer drugs developed TLS and three developed acute UAN despite being at low risk of TLS. The responses also showed that 67.5% of doctors tried to prevent TLS using antihyperuricemics agents even for patients at low risk of TLS. Thus, the present findings revealed that the Japanese TLS guidance for managing TLS does not appropriately classify the real-world risk 2019. Thus, the TLS guidance regarding treatment strategies should be revised as soon as possible.

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