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Year : 2019  |  Volume : 9  |  Issue : 3  |  Page : 264-267

T-cell acute lymphoblastic leukaemia, mild leucocytosis causes severe tumour lysis syndrome

1 Department of Clinical Hematology and Bone Marrow Transplant, Tata Medical Center, Kolkata, West Bengal, India
2 Malaysia Many Public University, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia

Correspondence Address:
Mainul Haque
Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kem Sungai Besi, 57000 Kuala Lumpur
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/AIHB.AIHB_66_19

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Tumour lysis syndrome (TLS) is a potentially life-threatening complication of the tumour. This syndrome consists of laboratory parameters such as hyperuricaemia, hyperkalaemia, hyperphosphataemia and hypocalcaemia and clinical complications such as acidosis, seizures, acute renal failure, cardiac arrhythmias and ultimately even death. TLS is especially standard in patients with haematological malignancies with rapid cellular turnover rates such as acute lymphocytic leukaemia, Burkitt lymphoma and diffuse large cell lymphoma, but is very rare in patients with solid tumours. T-cell acute lymphoblastic leukaemia is aggressive leukaemia, a subtype of acute lymphoblastic leukaemia accounts for 15% of children and 25% of adult acute lymphoblastic leukaemia. Diagnostic confirmation of T-cell acute lymphoblastic leukaemia (T-ALL) in this case done through utilising flow cytometry which is one of the best diagnostic tools for acute leukaemia, further diagnosed with a cortical T-ALL, a subtype of T-ALL, initially responded well in pre-phase induction chemotherapy (oral prednisolone 40 mg for 7 days). TLS developed after the 2nd day of 40 mg oral prednisolone with hyperkalaemia and hyperphosphataemia. The prevention of TLS now considered more effective than the treatment and identification of the high-risk patient and taking preventive support is a crucial research area. Herein, this manuscript discusses a case of the TLS the acute management.

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