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2011, Number 1

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Rev Hematol Mex 2011; 12 (1)

Impact of renal failure at diagnosis in adult patients wirh acute lymphoblastic leukemia: A single instiution experience

Ramos-Peñafiel C, Martínez-Murillo C, Castellanos-Sinco H, Montaño FE, Collazo JJ

Language: Spanish
References: 18
Page: 7-10
PDF size: 64.34 Kb.


ABSTRACT

Background: The acute lymphoid leukemia (ALL) is a lymphoproliferative neoplasm characterized by an uncontrolled proliferation of immature lymphoid cells. The renal failure may be present at diagnosis and also may be secondary to the use of chemotherapy. The renal infiltration by tumor cells is uncommon and has been linked to causes such as hyponatremia and hypocalcemia.
Material and Methods: We studied 165 patients with ALL who started treatment with the institutional protocol HGMLAL07/09 between December 2007 to june 2010.
Results: The median age was 33 years, 50.9% were male. About 19.3% (n=32) had hepatomegaly, 18.1% ( n=30) had splenomegaly and 29% (n=48) had lymph node enlargement. The 70.4% (n=116) were considered high risk. The median of WBC was 56.7 x 103/l (range 1-190 x 103/l). About 16.3% (n=27) of the patients had renal failure at diagnosis and only in a 11% (n=3) was associated with a tumor lysis syndrome. The renal failure are statistically associated with the risk (p=0.26), the visceromegalies (p=0.006) and hyperleukocytosis (p=0.003). The complete remission rate was 62.8% but the renal failure showed no impact on treatment failure (p=0.765).
Conclusion: In conclusion is necessary to identify all the factors that can precipitate a renal failure both pre and post-treatment, as well as consider various strategies to limit the progression of chronic renal failure.


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