Abstract:
Introduction Tumor lysis syndrome (TLS) is a life-threatening metabolic abnormality. The incidence of TLS depends on the underlying malignancy. In a recent analysis of hematological malignancy, the incidence of clinical TLS in children was 3.8%, laboratory TLS 46.2%, and hyperphosphatemia 32.7%. Sevelamer is effective for the treatment of hyperphosphatemia associated with renal failure; however, there is no clear data that it has the same effect in treating hyperphosphatemia with TLS. Methods This was a retrospective study among children aged ≤14 years with hematological malignancy who developed TLS and received sevelamer to treat hyperphosphatemia at Princess Norah Oncology Center, King Abdulaziz Medical City (KAMC) in Jeddah from January 2012 to December 2016. Results A total of 34 patients received sevelamer. The majority was male (64%), with a median age of six years. The median sevelamer dose per day was 1600 mg, while the median duration of use was two days. Phosphate level was significantly decreased at different times (24 hours, 48 hours, and 72 hours) during sevelamer usage, p-value <0.001. Conclusion In our study, the use of sevelamer resulted in a significant decrease in phosphate levels. This finding further consolidates the efficacy of sevelamer in treating hyperphosphatemia with TLS. However, further research into the drug\'s kinetics is recommended.
摘要:
引言肿瘤溶解综合征(TLS)是一种危及生命的代谢异常。TLS的发病率取决于潜在的恶性肿瘤。在最近对血液恶性肿瘤的分析中,儿童临床TLS的发生率为3.8%,实验室TLS46.2%,高磷血症32.7%。Sevelamer可有效治疗与肾功能衰竭相关的高磷血症;然而,没有明确的数据表明它在TLS治疗高磷血症方面具有相同的效果.方法回顾性研究年龄≤14岁的恶性血液病患儿,在诺拉公主肿瘤中心发生TLS并接受司维拉姆治疗高磷血症。2012年1月至2016年12月,吉达的阿卜杜勒阿齐兹国王医疗城(KAMC)。结果34例患者接受司维拉姆治疗。大多数是男性(64%),平均年龄为6岁。每天的中位司维拉姆剂量为1600毫克,而中位使用时间为2天。磷酸盐水平在不同时间显著降低(24小时,48小时,和72小时)在sevelamer使用期间,p值<0.001。结论在我们的研究中,司维拉姆的使用导致磷酸盐水平显着降低。这一发现进一步巩固了司维拉姆用TLS治疗高磷酸盐血症的功效。然而,建议进一步研究药物的动力学。