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Case 8
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
Laboratory tumour lysis syndrome≥2 abnormal serum biochemistry results, in the same 24-hour period within 3 days prior to treatment until 7 days after starting treatment. Urate ≥476 μmoL or >25% increase from baselinePotassium ≥6.0 mmol/L or >25% increase from baselinePhosphate ≥1.45 mmol/L or 25% increase from baselineCalcium ≤1.75 mmol/L or 25% decrease from baseline
Non-Hodgkin Lymphoma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Piers Blombery, David C. Linch
There are three forms of BL: endemic, sporadic, and immunodeficiency-associated. BL typically presents as rapidly progressive extra-nodal disease with frequent bone marrow, intestinal tract, and leptomeningeal disease. Nodal disease is more common in adults than in children and is often bulky.63 Both spontaneous tumor lysis syndrome (i.e., preceding treatment) and treatment-induced tumor lysis syndrome are common in BL and are important contributors to early morbidity and mortality. Rigorous hydration and recombinant urate oxidase are now routinely used in patients with BL.64
Clinical Studies In Oncology
Published in Siegfried Matzku, Rolf A. Stahel, Antibodies in Diagnosis and Therapy, 2019
Jan Schmielau, Wolff Schmiegel
In order to augment tumor infiltration Minasian et al. (1994) added TNF-α to the anti-GD3 antibody therapy of malignant melanoma in seven patients. One patient developed a tumor lysis syndrome within hours after treatment, but the remaining patients had tumor progression. Ex vivo experiments demonstrated an increased respiratory burst of neutrophils after treatment, although antibody-independent cytotoxicity did not change. ADCC of neutrophils from treated patients were not tested.
Initiation of a new anti-cancer medical treatment in ICU: a retrospective study
Published in Acta Clinica Belgica, 2022
Maxence Chicoisneau, Marianne Paesmans, Lieveke Ameye, Jean-Paul Sculier, Anne-Pascale Meert
Our study consists of 147 patients, 78 men (53%) and 69 women (47%), with a median age of 58 years (18–86). Amongst them, we find 80 (54%) with a solid tumor (59 lung cancer, 7 breast cancer, 5 digestive track tumor, 4 head and neck cancer and 4 others)(including 69 metastatic) and 67 (46%) with a hematological tumor (41 leukemia, 21 lymphoma and 6 others) (including 7 having received a bone marrow transplant). Eighteen patients (12%) were admitted to intensive care from home, 51 (35%) through emergency unit and 73 (50%) were already hospitalized. The median lengths of ICU and hospital stays were, respectively, 8 days and 14 days. Performance status was not found in the medical records of 80 patients (54%). Sixty-six patients (45%) had a tumor lysis syndrome risk score of 1, 60 patients (41%) of 2 and 21 patients (14%) of 3.
Cyclin-dependent kinase (CDK) 9 and 4/6 inhibitors in acute myeloid leukemia (AML): a promising therapeutic approach
Published in Expert Opinion on Investigational Drugs, 2019
Daniel J. Lee, Joshua F. Zeidner
Given that single agent alvocidib did not demonstrate substantial clinical activity, a phase I trial was conducted to determine the MTD and RP2D of hybrid alvocidib when given with the same timed sequential cytarabine and mitoxantrone regimen that was studied with bolus alvocidib (FLAM). Fifty-five adults with relapsed/refractory AML (n = 49), ALL (n = 3), and biphenotypic leukemia (n = 3) were enrolled. Tumor lysis syndrome was observed in 51% of participants, and significant cardiac toxicities occurred in 9% of subjects. The MTD and RP2D of alvocidib was determined to be 30 mg/m2 bolus with 60 mg/m2 infusions. The overall CR rate was 40%, and an additional 5% achieved PR, for an ORR of 45%. The CR rate at the RP2D was 52%. Of the participants who were in CR, 73% underwent allogeneic stem cell transplant. Median OS was 7.4 months, and median DFS was not reached (range 1.8 to 30 months) at the time of publication [58].
The future of chronic lymphocytic leukemia: potential directions from ASH 2017
Published in Expert Review of Hematology, 2018
At 2 years of follow-up, median PFS was not yet reached in the venetoclax/rituximab arm versus 17 months for BR. These findings were confirmed in an independent review evaluation. Of note, PFS was consistent across subgroups for clinical and biologic features. Secondary end points, including overall survival, favored venetoclax/rituximab. Patients treated with venetoclax/rituximab had a 52% reduced risk of death. MRD negativity [defined as <1 CLL cell in 10,000 leukocytes] was higher with venetoclax/rituximab at every time point. The overall rate of peripheral blood MRD negativity at any time on study was 83.5% with venetoclax/rituximab versus 23.1% with BR. No new safety signals emerged for any of the drugs. Serious AEs were reported in 46% of the venetoclax/rituximab arm versus 43% of the BR arm. Grade 3/4 AEs were reported in 82% and 70%, respectively. Grade 3/4 neutropenia was more common in the venetoclax/rituximab arm: 58% versus 39%. Infections were relatively infrequent. Tumor lysis syndrome occurred in 3% versus 1%. Finally, most of the toxicities seen with the venetoclax/rituximab combination occurred before obtaining disease control [24,25].