High risk:
(1) Burkitt's lymphoma
(2) lymphoblastic lymphoma
(3) Burkitt's ALL
(4) ALL AND WBC count >= 100,000 per µL
(5) AML AND WBC >= 50,000 per µL
(6) AML AND monoblastic (M5 in the FAB)
(7) CLL AND WBC >= 10,000 per µL
Intermediate risk:
(1) diffuse large B-cell lymphoma
(2) ALL AND WBC count > 50,000 per µL AND < 100,000 per µL
(3) AML AND WBC > 10,000 per µL AND < 50,000 per µL
(4) CLL AND WBC > 10,000 per µL AND < 100,000 per µL
(5) other type of hematologic malignancy that is rapidly proliferating and that shows a rapid response to therapy
(6) solid tumor that is rapidly proliferating and that shows a rapid response to therapy
Low risk:
(1) indolent form of non-Hodgkin's lymphoma
(2) ALL AND WBC count <= 50,000 per µL
(3) AML AND WBC <= 10,000 per µL
(4) CLL AND WBC <= 10,000 per µL
(5) none of the above
|
Risk Group
|
Initial Management
|
Medication
|
|
low
|
monitor and observe
|
NA
|
|
intermediate
|
hydrate and monitor
|
allopurinol; if pediatric patient or hyperuricemia develops then rasburicase
|
|
high
|
hydrate and monitor
|
rasburicase
|
