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Management of hyperleucocytosis and prevention of tumor lysis syndrome by adminstration of L-asparginase in children with acute lymphoblastic leukemia

In Pediatric Blood and Cancer
By: Sondhi V.
Contributor(s): Chitalkar PG | Banavali SD | Arora B | Dwivedi P | Katoch MC | .
Material type: materialTypeLabelArticleSeries: Vol 59 Issues 6.Publisher: 2012Description: 1033.Subject(s): Acute lymphoblastic leukemia | Children | L-asparginase | Tumor lysis syndrome | Prevention | Hyperleucocytosis | DDC classification: In: Pediatric Blood and CancerSummary: Purpose: Acute lymphoblastic leukemias (ALL) may present with high blast counts. Cytoreductive therapies including exchange transfusion, and leukapharesis, need expensive equipment and trained staff, while steroid administration, is associated with tumor lysis syndrome (TLS). The efficacy of other induction chemotherapeutic drugs to bring about cytoreduction without precipitating TLS is not known. In this study, the patients with hyperleucocytic ALL were treated with single chemotherapeutic agent L-Asparginase along with supportive treatment and its effect on white blood cell (WBC) count and precipitation of TLS was assessed. Methods: Between April 2010 and February 2012, all children of ALL 12y age, presenting with WBC count >100109/L were included. All the patients were administered intravenous fluids (3 L/m2/24 h), and allopurinol on admission. One dose of L-Asparginase (6000 U/m2, intramuscular) was administered after confirmation of morphological diagnosis and drawing samples for cytochem
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Purpose: Acute lymphoblastic leukemias (ALL) may present with high blast counts.
Cytoreductive therapies including exchange transfusion, and leukapharesis, need expensive
equipment and trained staff, while steroid administration, is associated with tumor lysis
syndrome (TLS). The efficacy of other induction chemotherapeutic drugs to bring about
cytoreduction without precipitating TLS is not known. In this study, the patients with
hyperleucocytic ALL were treated with single chemotherapeutic agent L-Asparginase along
with supportive treatment and its effect on white blood cell (WBC) count and precipitation of
TLS was assessed.
Methods: Between April 2010 and February 2012, all children of ALL 12y age, presenting
with WBC count >100109/L were included. All the patients were administered
intravenous fluids (3 L/m2/24 h), and allopurinol on admission. One dose of L-Asparginase
(6000 U/m2, intramuscular) was administered after confirmation of morphological diagnosis
and drawing samples for cytochem

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