Journal des troubles sanguins et de la transfusion

Abstrait

Identification of Children with Acute Lymphoblastic Leukemia at Low Risk for Tumor Lysis Syndrome

Bahoush GR, Yazdi E, Ansari SH, Arjmandi KH and Vossough P

Purpose: We determined the prevalence and predictors of TLS in children with acute lymphoblastic leukemia to develop a sensitive prediction rule to identify low risk patients.

Methods: Predictors of TLS were determined in 160 childern with ALL, using univariate and multiple logistic regression analyses. Results: TLS was diagnosed in 41 cases. Univariate analysis showed splenomegaly, mediastinal mass, T-cell phenotype, central nervous system involvement, lactate dehydrogenase ≥2000 U/L, and white blood count (WBC) ≥20 × 109 /L (P<0.001) were predictors of TLS in these cases. Multiple regression analysis of variables identified CNS and renal involvement, mediastinal mass, and initial WBC ≥ 20 × 109 /L as independent predictors of TLS.

Conclusions: The above predictors could evaluate the risk of TLS in hematologic malignancies before initiative chemotherapy. Finding a model of independent factors to define a group of ALL children at low risk of TLS could be used to prevent cost of prophylactic treatment modalities.