SFCE (Societe Francaise des Cancers de l’Enfant) Recommendations for the Management of Tumor Lysis Syndrome (TLS): A Validation Survey.

TLS is a metabolic complication of haematological malignancies, which can translate in renal impairment. As previously described (

Patients and Methods: HR pts were defined as: Acute Lymphoblastic (ALL) or Myeloblastic (AML) Leukaemia with initial leucocytes counts of at least 50x10⁹/L, B cell ALL, Stage III and IV T or B Non Hodgkin Lymphoma (NHL), any leukaemia or NHL with a plasma uric acid concentration (U) of at least 300mmoles/L if ≤ 10 years old or 350mmoles/L if ≥ 10 years old, or any disease with serum creatinine (C) or lactate deshydrogenase concentration (LDH) exceeding twice the upper limit of normal (N), hyperphosphatemia (P)≥ 2 mmoles/L. These pts received hydration (3L/m²) ± alkalinization and R 0,20 mg/kg/d x 5 days. If C >1,5 N or P> 3mmoles/L or U ≥ 200mmoles/l, R administration is prolonged until normalization. Low risk (LR) pts, defined as not HR, received hydration 3L/m² and R 0,20 mg/kg/for only one day. R could be prolonged according to the same criteria as HR pts.

Results: Between May and December 2004, 174 patients including 91 boys and 83 girls (median age 5 years) were treated according to these recommendations, in 8 centers in France. Initial diagnosis was LA in141 and NHL in 33. 143 patients (82%) were classified HR and 31 LR (18%). In the HR group, the patients received a median of 5 days of treatment with R (1–12) and in the LR group a median of 1 day (0–5). 25% of HR patients required treatment prolongation, while the LR group treatment prolongation was needed for 1 patient (3%). No complication of TLS was observed.

Conclusions: these results show that the risk classification as established by the SFCE was accurate and that the treatment guidelines was effective for the control of hyperuricemia and TLS.