Reactions 1426 - 3 Nov 2012

SAntineoplastics

Tumour lysis syndrome in an elderly patient:case report

A 69-year-old man developed tumour lysis syndromewhile receiving cisplatin and gimeracil/oteracil/tegafur[routes not stated] for advanced gastric cancer; he laterdied.

The man started systemic antineoplastic therapy withcisplatin and gimeracil/oteracil/tegafur; due to thepossibility of latent tumour lysis syndrome, treatment wasinitiated at the lower dosages of 85mg (day 8) and80 mg/day (days 1–21), respectively. On day 3 oftreatment, his urine volume decreased and his levels ofLDH, potassium and uric acid increased. Laboratorytumour lysis syndrome was diagnosed. He was treatedwith furosemide and allopurinol, with improvement in hislaboratory parameters. However, upon administration ofcisplatin on day 8 of treatment, his LDH, potassium,phosphorus, uric acid and creatinine levels increased.

Antineoplastic therapy was withdrawn and the man’slaboratory parameters again improved. He developed lungand liver metastases and palliative care was pursued. Hisconsciousness level declined and blood testing disclosed asudden increase in levels of LDH, potassium, phosphorus,uric acid and creatinine. He died of acute renal failure onday 30.

Author comment: Tumour lysis syndrome is a seriouscomplication that can be induced by systemic chemotherapy.Levels of LDH had transiently increased just prior tochemotherapy and chemotherapy was begun in order tocontrol the patient’s condition, but this led to further tumourlysis.Kobayashi T, et al. Acute tumor lysis syndrome in the setting of advanced gastriccancer. Nihon Shokakibyo Gakkai Zasshi / Japanese Journal of Gastroenterology109: 1372-1378, No. 8, Aug 2012 [Japanese; summarised from a translation] -Japan 803079325

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Reactions 3 Nov 2012 No. 14260114-9954/10/1426-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved