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Clinical characteristics of tumor lysis syndrome in childhood acute lymphoblastic leukemia(Open Access)

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机构： [1]Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing,China [2]Key Laboratory of Hematology, Nanjing Medical University, No.72 Guangzhou Road, Nanjing 210008,China [3]Department of Hematology/Oncology, Shanghai Children’s Medical Center, National Health CommitteeKey Laboratory of Pediatric Hematology & Oncology, School of Medicine, Shanghai Jiao Tong University,Shanghai, China [4]Department of Hematology/Oncology, Ministry of Education Key Laboratory of ChildDevelopment and Disorders, National Clinical Research Center for Child Health and Disorders, China InternationalScience and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing KeyLaboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China [5]HematologyDepartment, Children’s Hospital of Fudan University, Shanghai, China [6]Department of Pediatric, The SecondHospital of Anhui Medical University, Hefei, China [7]Department of Pediatrics, West China Second UniversityHospital, Sichuan University, Key Laboratory of Birth Defects and Related Disease of Women and Children,Ministry of Education, Chengdu, China [8]Department of Hematology, Kunming Children’s Hospital, Kunming,China [9]Department of Pediatric Hematology, Tongji Hospital of Tongji Medical College, Huazhong Universityof Science and Technology, Wuhan, China [10]Department of Pediatrics, Qilu Hospital of Shandong University,Jinan, China [11]Department of Hematology and Oncology, Guangzhou Women and Children’s Medical Center,Guangzhou, China [12]State Key Laboratory of Experimental Hematology and Division of Pediatric Blood DiseasesCenter, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and PekingUnion Medical College, Tianjin, China [13]Department of Pediatrics, Nanfang Hospital, Southern Medical University,Guangzhou, China [14]Department of Pediatrics, Hong Kong Children’s Hospital, The Chinese University ofHong Kong, Hong Kong, SAR, China [15]Department of Hematology/Oncology, Children’s Hospital of SoochowUniversity, Suzhou, China [16]Department of Hematology/Oncology, Jiangxi Provincial Children’s Hospital,Nanchang, China [17]Department of Pediatrics, Union Hospital of Tongji Medical College, Huazhong University ofScience and Technology, Wuhan, China [18]Department of Hematology/Oncology, Shanghai Children’s Hospital,Shanghai Jiao Tong University, Shanghai, China [19]Department of Pediatrics, Xiangya Hospital Central SouthUniversity, Changsha, China [20]Department of Pediatrics, Affiliated Hospital of Qingdao University, Qingdao,China [21]Department of Hematology/Oncology, Northwest Women’s and Children’s Hospital, Xi’an, China

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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. © 2021, The Author(s).

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出版当年[2021]版：

大类 | 3 区综合性期刊

小类 | 3 区综合性期刊

最新[2023]版：

大类 | 2 区综合性期刊

小类 | 2 区综合性期刊

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出版当年[2021]版：

Q2 MULTIDISCIPLINARY SCIENCES

最新[2023]版：

Q1 MULTIDISCIPLINARY SCIENCES

影响因子： 3.8 最新[2023版] 4.3 最新五年平均 4.997 出版当年[2021版] 5.516 出版当年五年平均 4.38 出版前一年[2020版] 4.6 出版后一年[2022版]

第一作者：

第一作者机构： [1]Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing,China [2]Key Laboratory of Hematology, Nanjing Medical University, No.72 Guangzhou Road, Nanjing 210008,China

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通讯作者：

通讯机构： [1]Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing,China [2]Key Laboratory of Hematology, Nanjing Medical University, No.72 Guangzhou Road, Nanjing 210008,China

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