Clinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia
Abstract Tumor lysis syndrome (TLS) is a common and fatal complication of childhood hematologic malignancies, especially acute lymphoblastic leukemia (ALL). The clinical features, therapeutic regimens, and outcomes of TLS have not been comprehensively analyzed in Chinese children with ALL. A total o...
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Nature Portfolio
2021
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oai:doaj.org-article:395a3d2f1711449b903e2f29b15549cc2021-12-02T14:49:26ZClinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia10.1038/s41598-021-88912-22045-2322https://doaj.org/article/395a3d2f1711449b903e2f29b15549cc2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88912-2https://doaj.org/toc/2045-2322Abstract Tumor lysis syndrome (TLS) is a common and fatal complication of childhood hematologic malignancies, especially acute lymphoblastic leukemia (ALL). The clinical features, therapeutic regimens, and outcomes of TLS have not been comprehensively analyzed in Chinese children with ALL. A total of 5537 children with ALL were recruited from the Chinese Children’s Cancer Group, including 79 diagnosed with TLS. The clinical characteristics, treatment regimens, and survival of TLS patients were analyzed. Age distribution of children with TLS was remarkably different from those without TLS. White blood cells (WBC) count ≥ 50 × 109/L was associated with a higher risk of TLS [odds ratio (OR) = 2.6, 95% CI = 1.6–4.5]. The incidence of T-ALL in TLS children was significantly higher than that in non-TLS controls (OR = 4.7, 95% CI = 2.6–8.8). Hyperphosphatemia and hypocalcemia were more common in TLS children with hyperleukocytosis (OR = 2.6, 95% CI = 1.0–6.9 and OR = 5.4, 95% CI = 2.0–14.2, respectively). Significant differences in levels of potassium (P = 0.004), calcium (P < 0.001), phosphorus (P < 0.001) and uric acid (P < 0.001) were observed between groups of TLS patients with and without increased creatinine. Laboratory analysis showed that older age was associated with a higher level of creatinine. Calcium level was notably lower in males. WBC count, lactate dehydrogenase, and creatinine levels were significantly higher in T-ALL subgroup, whereas procalcitonin level was higher in B-ALL children. Older age, infant, a higher level of WBC and T-ALL were risk factors TLS occurrence. Hyperleukocytosis has an impact on the severity of TLS, while renal injury may be an important feature in the process of TLS.Yao XueJing ChenSiyuan GaoXiaowen ZhaiNingling WangJu GaoYu LvMengmeng YinYong ZhuangHui ZhangXiaofan ZhuXuedong WuChi Kong LiShaoyan HuChangda LiangRunming JinHui JiangMinghua YangLirong SunKaili PanJiaoyang CaiJingyan TangXianmin GuanYongjun FangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021) |
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DOAJ |
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DOAJ |
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Medicine R Science Q |
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Medicine R Science Q Yao Xue Jing Chen Siyuan Gao Xiaowen Zhai Ningling Wang Ju Gao Yu Lv Mengmeng Yin Yong Zhuang Hui Zhang Xiaofan Zhu Xuedong Wu Chi Kong Li Shaoyan Hu Changda Liang Runming Jin Hui Jiang Minghua Yang Lirong Sun Kaili Pan Jiaoyang Cai Jingyan Tang Xianmin Guan Yongjun Fang Clinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia |
| description |
Abstract Tumor lysis syndrome (TLS) is a common and fatal complication of childhood hematologic malignancies, especially acute lymphoblastic leukemia (ALL). The clinical features, therapeutic regimens, and outcomes of TLS have not been comprehensively analyzed in Chinese children with ALL. A total of 5537 children with ALL were recruited from the Chinese Children’s Cancer Group, including 79 diagnosed with TLS. The clinical characteristics, treatment regimens, and survival of TLS patients were analyzed. Age distribution of children with TLS was remarkably different from those without TLS. White blood cells (WBC) count ≥ 50 × 109/L was associated with a higher risk of TLS [odds ratio (OR) = 2.6, 95% CI = 1.6–4.5]. The incidence of T-ALL in TLS children was significantly higher than that in non-TLS controls (OR = 4.7, 95% CI = 2.6–8.8). Hyperphosphatemia and hypocalcemia were more common in TLS children with hyperleukocytosis (OR = 2.6, 95% CI = 1.0–6.9 and OR = 5.4, 95% CI = 2.0–14.2, respectively). Significant differences in levels of potassium (P = 0.004), calcium (P < 0.001), phosphorus (P < 0.001) and uric acid (P < 0.001) were observed between groups of TLS patients with and without increased creatinine. Laboratory analysis showed that older age was associated with a higher level of creatinine. Calcium level was notably lower in males. WBC count, lactate dehydrogenase, and creatinine levels were significantly higher in T-ALL subgroup, whereas procalcitonin level was higher in B-ALL children. Older age, infant, a higher level of WBC and T-ALL were risk factors TLS occurrence. Hyperleukocytosis has an impact on the severity of TLS, while renal injury may be an important feature in the process of TLS. |
| format |
article |
| author |
Yao Xue Jing Chen Siyuan Gao Xiaowen Zhai Ningling Wang Ju Gao Yu Lv Mengmeng Yin Yong Zhuang Hui Zhang Xiaofan Zhu Xuedong Wu Chi Kong Li Shaoyan Hu Changda Liang Runming Jin Hui Jiang Minghua Yang Lirong Sun Kaili Pan Jiaoyang Cai Jingyan Tang Xianmin Guan Yongjun Fang |
| author_facet |
Yao Xue Jing Chen Siyuan Gao Xiaowen Zhai Ningling Wang Ju Gao Yu Lv Mengmeng Yin Yong Zhuang Hui Zhang Xiaofan Zhu Xuedong Wu Chi Kong Li Shaoyan Hu Changda Liang Runming Jin Hui Jiang Minghua Yang Lirong Sun Kaili Pan Jiaoyang Cai Jingyan Tang Xianmin Guan Yongjun Fang |
| author_sort |
Yao Xue |
| title |
Clinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia |
| title_short |
Clinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia |
| title_full |
Clinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia |
| title_fullStr |
Clinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia |
| title_full_unstemmed |
Clinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia |
| title_sort |
clinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/395a3d2f1711449b903e2f29b15549cc |
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