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Predictive Factors of Truong et al for Tumor Lysis Syndrome in a Pediatric Patient with Acute Lymphoblastic Leukemia (ALL)

Description

Truong et al identified factors at initial presentation which were associated with tumor lysis syndrome (TLS) in pediatric patients with acute lymphoblastic leukemia (ALL). These can help identify patients who may or who may not need interventions to reduce complications. The authors are from the University of Toronto.


 

Patients: ALL with onset <= 18 years of age

 

Parameters present at presentation that were identified on multiple regression analysis:

(1) age of the patient in years

(2) spleen size

(3) mediastinal mass

(4) white blood cell count

Parameter

Finding

Points

age in years

< 10 years

0

 

>= 10 years

1

spleen size

splenomegaly absent

0

 

splenomegaly present

1

mediastinal mass

absent

0

 

present

1

white blood cell count

< 20,000 per µL

0

 

>= 20,000 per µL

1

 

total number of risk factors =

= SUM(points for all 4 factors)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 4

• The more risk factors that are present the greater the risk for TLS.

• A patient no risk factors has a low risk of TLS.

 

Additional risk factors:

(1) male gender

(2) T-cell ALL

(3) CNS involvement

(4) serum LDH >= 2,000 IU/L

 


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