Successful treatment of a patient with tumor lysis syndrome using high-efficiency daily diafiltration technique to avoid further tumor lysis during chemotherapy

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  • Hayakawa Seiko
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Nishida Osamu
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Nakamura Tomoyuki
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Hara Yoshitaka
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Yamashita Chizuru
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Shibata Jyunpei
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Niimi Daisuke
    Nishichita General Hospital Department of Anesthesiology and Critical Care Medicine
  • Kawata Kohtaroh
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Uchiyama Sohta
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Akiyama Masayoshi
    Nishichita General Hospital Department of Anesthesiology and Critical Care Medicine
  • Komatsu Satoshi
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Maeda Takayasu
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Yanagi Akio
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Takagi Saori
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Moriyama Kazuhiro
    Laboratory for Immune Response and Regulatory Medicine, Fujita Health University School of Medicine
  • Okamoto Akinao
    Department of Hematology, Fujita Health University School of Medicine

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Other Title
  • 腫瘍崩壊症候群を回避するために間歇的高効率血液浄化療法を用い救命した症例
  • 症例報告 腫瘍崩壊症候群を回避するために間歇的高効率血液浄化療法を用い救命した症例
  • ショウレイ ホウコク シュヨウ ホウカイ ショウコウグン オ カイヒ スル タメニ カンケツテキ コウコウリツ ケツエキ ジョウカ リョウホウ オ モチイ キュウメイ シタ ショウレイ

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Abstract

<p>We recently experienced a patient with tumor lysis syndrome (TLS) secondary to Burkitt’s lymphoma who was successfully treated with a combination of chemotherapy and sustained high-efficiency daily diafiltration using a mediator adsorbing membrane (SHEDD-fA) without any deterioration in his clinical condition. [Case] A man in his 60s was admitted to the intensive care unit (ICU) due to the exacerbation of Burkitt’s lymphoma complicated with pneumonia and disseminated intravascular coagulation. He was diagnosed with spontaneous TLS presenting with extreme acidosis, hyperkalemia, hyperuricemia, anuria, and life-threatening electrolyte abnormalities and renal failure. SHEDD-fA was performed immediately, and his general condition gradually improved. On days 2 and 3 after the patient’s ICU admission, prednisolone (1mg/kg/day) was administered. After confirming that the patient’s condition had not significantly deteriorated, combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) was started on day 4. No TLS-induced adverse events occurred during the course of the chemotherapy. Although it is avoidable to give chemotherapy in patients with high-grade lymphomas occurring spontaneous TLS, we conclude that SHEDD-fA potentially enables chemotherapy more safe.</p>

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