Al Blewi Sawsan M, AlAzmi Aeshah A, Elimam Nagla, Jastaniah Wasil, Mohammedkhalil Abdullah, Abdullah Shaker
Department of Pediatrics, University of Tabuk, Tabuk, SAU.
Department of Pediatric Oncology Hematology Bone Marrow Transplan, King Abdulaziz Medical City Jeddah, Princess Noorah Oncology Center, Jeddah, SAU.
Cureus. 2023 Jan 9;15(1):e33533. doi: 10.7759/cureus.33533. eCollection 2023 Jan.
Introduction Tumor lysis syndrome (TLS) is a life-threatening metabolic abnormality. The incidence of TLS depends on the underlying malignancy. In a recent analysis of hematological malignancy, the incidence of clinical TLS in children was 3.8%, laboratory TLS 46.2%, and hyperphosphatemia 32.7%. Sevelamer is effective for the treatment of hyperphosphatemia associated with renal failure; however, there is no clear data that it has the same effect in treating hyperphosphatemia with TLS. Methods This was a retrospective study among children aged ≤14 years with hematological malignancy who developed TLS and received sevelamer to treat hyperphosphatemia at Princess Norah Oncology Center, King Abdulaziz Medical City (KAMC) in Jeddah from January 2012 to December 2016. Results A total of 34 patients received sevelamer. The majority was male (64%), with a median age of six years. The median sevelamer dose per day was 1600 mg, while the median duration of use was two days. Phosphate level was significantly decreased at different times (24 hours, 48 hours, and 72 hours) during sevelamer usage, p-value <0.001. Conclusion In our study, the use of sevelamer resulted in a significant decrease in phosphate levels. This finding further consolidates the efficacy of sevelamer in treating hyperphosphatemia with TLS. However, further research into the drug's kinetics is recommended.
引言 肿瘤溶解综合征（TLS）是一种危及生命的代谢异常。TLS的发病率取决于潜在的恶性肿瘤。在最近一项对血液系统恶性肿瘤的分析中，儿童临床TLS的发病率为3.8%，实验室TLS为46.2%，高磷血症为32.7%。司维拉姆对治疗与肾衰竭相关的高磷血症有效；然而，尚无明确数据表明其在治疗TLS相关高磷血症时具有相同效果。方法 这是一项回顾性研究，研究对象为2012年1月至2016年12月在吉达阿卜杜勒阿齐兹国王医疗城（KAMC）诺拉公主肿瘤中心发生TLS并接受司维拉姆治疗高磷血症的14岁及以下血液系统恶性肿瘤儿童。结果 共有34例患者接受了司维拉姆治疗。大多数为男性（64%），中位年龄为6岁。司维拉姆的每日中位剂量为1600毫克，中位使用时间为2天。在司维拉姆使用期间的不同时间点（24小时、48小时和72小时），磷酸盐水平显著降低，p值<0.001。结论 在我们的研究中，使用司维拉姆导致磷酸盐水平显著降低。这一发现进一步巩固了司维拉姆治疗TLS相关高磷血症的疗效。然而，建议对该药物的动力学进行进一步研究。
