Paediatrician, Department of Paediatrics and Child Health, Case Hospital, Kampala, Uganda.
Lecturer, Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Trop Doct. 2021 Oct;51(4):501-507. doi: 10.1177/00494755211029782. Epub 2021 Jul 7.
High-grade malignancy is endemic in sub-Saharan Africa and is prone to the spontaneous tumour lysis syndrome. However, data on spontaneous tumour lysis syndrome remain scanty in our setting. We sought to determine the prevalence and factors associated with laboratory spontaneous tumour lysis syndrome in children in Uganda. We conducted a cross-sectional study among children <18 years old with histologically confirmed high-grade malignancy between October 2013 and April 2014. Laboratory spontaneous tumour lysis syndrome was defined as the presence of ≥2 of each of hyperkalaemia, hypocalcaemia, hyperuricaemia and hyperphosphatemia prior to administration of chemotherapy when alternative diagnoses had been excluded. A p < 0.05 was considered statistically significant. Of 108 children, of median age 7.7 years, where boys outnumbered girls 2:1, high-grade, malignancy included Burkitt's lymphoma, acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, acute myeloid leukaemia and Burkitt's leukaemia, with 14 suffering with laboratory spontaneous tumour lysis syndrome. Hypocalcaemia was its most common electrolyte imbalance; and four children died prior to commencement of chemotherapy. Bulky disease, lactate dehydrogenase levels ≥500 iu/l and serum creatinine levels >1.2 mg/dl were associated with laboratory spontaneous tumour lysis syndrome. However, only bulky disease was significantly predictive of laboratory spontaneous tumour lysis syndrome. Such children would benefit from routine screening.
高级别恶性肿瘤在撒哈拉以南非洲地区很常见，且易并发自发性肿瘤细胞溶解综合征。然而，在我们的环境中，关于自发性肿瘤细胞溶解综合征的数据仍然很少。我们旨在确定乌干达儿童中实验室自发性肿瘤细胞溶解综合征的患病率和相关因素。我们在 2013 年 10 月至 2014 年 4 月期间对 18 岁以下经组织学证实患有高级别恶性肿瘤的儿童进行了一项横断面研究。实验室自发性肿瘤细胞溶解综合征的定义为在接受化疗前存在≥2 种以下异常：高钾血症、低钙血症、高尿酸血症和高磷血症，且已排除其他诊断。p 值<0.05 被认为具有统计学意义。在 108 名儿童中，中位年龄为 7.7 岁，男孩是女孩的 2:1，高级别恶性肿瘤包括伯基特淋巴瘤、急性淋巴细胞白血病、非霍奇金淋巴瘤、急性髓细胞白血病和伯基特白血病，其中 14 例患有实验室自发性肿瘤细胞溶解综合征。低钙血症是最常见的电解质失衡；有 4 名儿童在开始化疗前死亡。大肿块疾病、乳酸脱氢酶水平≥500 iu/l 和血清肌酐水平>1.2 mg/dl 与实验室自发性肿瘤细胞溶解综合征相关。然而，只有大肿块疾病与实验室自发性肿瘤细胞溶解综合征显著相关。这些儿童将受益于常规筛查。
