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Acute tumour lysis syndrome following a single-dose corticosteroid in children with acute lymphoblastic leukaemia

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Abstract: Acute tumour lysis syndrome (ATLS) is a well recognised complication of treatment of a variety of malignant disorders. It commonly occurs in patients with non-Hodgkin's lymphoma (NHL) and acute lymphoblastic leukaemia (ALL) with the administration of combined cytotoxic chemotherapy. It is rarely reported after single-agent corticosteroid therapy. We present two children with acute lymphoblastic leukaemia of T-cell lineage who developed acute tumour lysis syndrome after a single dose of prednisolone, and methylprednisolone at the beginning of the induction chemotherapy. In the first case (an 11-yr-old) ATLS had occurred after an oral dose of prednisolone as small as 12 mg and within 18 h. The second case was a 14-yr-old boy with ALL who developed ATLS following a single dose of methylprednisolone. A few similar cases in the English literature are summarised in the report. These cases indicate that acute tumour lysis syndrome may occur after a single dose of corticosteroids. One should be aware of this potentially life-threatening complication especially while prescribing corticosteroids to patients with NHL and leukaemia.
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Keywords: acute lymphoblastic leukaemia; methylprednisolone; prednisolone; tumour lysis

Document Type: Research Article

Affiliations: 1: Department of Pediatrics, Pediatric Nephrology and Rheumatology Unit, and 2: Department of Pediatrics, Pediatric Hematology Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey

Publication date: June 1, 2001

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