Akande Manzilat, Audino Anthony N, Tobias Joseph D
Division of Pediatric Critical Care Medicine (MA), Nationwide Children's Hospital, Columbus, Ohio, Department of Pediatrics (MA, ANA), The Ohio State University College of Medicine, Columbus, Ohio, Division of Pediatric Hematology/Oncology/BMT (ANA), Nationwide Children's Hospital, Columbus Ohio, Department of Anesthesiology & Pain Medicine (JTD), Nationwide Children's Hospital, Columbus, Ohio, and Department of Anesthesiology & Pain Medicine (JTD), The Ohio State University College of Medicine, Columbus, Ohio.
J Pediatr Pharmacol Ther. 2017 Nov-Dec;22(6):471-475. doi: 10.5863/1551-6776-22.6.471.
Rasburicase, used in the prevention and treatment of tumor lysis syndrome (TLS), may cause hemolytic anemia and methemoglobinemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Although routine screening for G6PD deficiency has been recommended, given the turnaround time for test results and the urgency to treat TLS, such screening may not be feasible. We report a case of rasburicase-induced hemolytic anemia without methemoglobinemia in an adolescent with T-cell lymphoblastic lymphoma, TLS, and previously unrecognized G6PD deficiency. Previous reports of hemolytic anemia with rasburicase are reviewed, mechanisms discussed, and preventative strategies presented.
拉布立酶用于预防和治疗肿瘤溶解综合征（TLS），可导致葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症患者发生溶血性贫血和高铁血红蛋白血症。尽管已建议对G6PD缺乏症进行常规筛查，但考虑到检测结果的周转时间以及治疗TLS的紧迫性，这种筛查可能并不可行。我们报告了1例青少年T细胞淋巴母细胞淋巴瘤合并TLS且既往未识别出G6PD缺乏症患者，该患者发生了由拉布立酶引起的无高铁血红蛋白血症的溶血性贫血。本文回顾了既往关于拉布立酶所致溶血性贫血的报告，讨论了其机制，并提出了预防策略。
