Spontaneous Fatal Tumor Lysis Syndrome in a Patient with T-Cell Lymphoblastic Lymphoma/Leukemia: Successful Treatment with Continuous Renal Replacement Therapy and Increasing-Dose Gradually Chemotherapy

Tumor Lysis Syndrome (TLS) results from massive necrosis or apoptosis of large proliferating tumors and is characterized by marked hyper uricemia, hyperkalemia, and hyper phosphatemia secondary to cell lysis and the metabolism of excessive nucleic acids. Clinically significant TLS, with end-organ compromise, occurs in approximately 5% of all patients with hematologic malignancies and in up to 25% of highrisk patients, including those with T-cell acute lymphoblastic leukemia and Burkitt’s lymphoma. TLS is a phenomena frequently occurs after the initiation of therapy, while spontaneous TLS occurring in the absence of chemotherapy, is rare but might portend a worse prognosis. We present a case of spontaneous TLS treated successfully with continuous renal replacement therapy and increasing-dose gradually chemotherapy in a boy with T-cell lymphoblastic lymphoma/ leukemia.