Venetoclax-induced tumor lysis syndrome
10.3760/cma.j.cn114015-20240918-00050
- VernacularTitle:维奈克拉致肿瘤溶解综合征
- Author:
Ningning GUO
1
;
Yanli ZHANG
Author Information
1. 烟台市莱阳中心医院临床药学科，莱阳 265200
- Publication Type:Journal Article
- Keywords:
Tumor lysis syndrome;
Leukemia, myeloid, acute;
Venetoclax
- From:
Adverse Drug Reactions Journal
2025;27(4):248-251
- CountryChina
- Language:Chinese
-
Abstract:
A 70-year-old male patient was treated with venetoclax 100 mg orally once daily for acute myeloid leukemia. Before treatment, laboratory tests showed serum potassium 3.61 mmol/L, serum calcium 1.88 mmol/L, inorganic phosphate 1.33 mmol/L, serum uric acid 276.3 μmol/L, aspartate aminotransferase (AST) 23 U/L, gamma-glutamyl transferase (GGT) 179 U/L, and lactate dehydrogenase (LDH) 797 U/L. Six hours later of medication, the patient experienced chest tightness, wheezing, fever with chills, and the highest body temperature was 38.3 ℃. Laboratory tests showed serum potassium 5.54 mmol/L, serum calcium 1.76 mmol/L, inorganic phosphate 3.41 mmol/L, serum uric acid 827.2 μmol/L, AST 205 U/L, GGT 157 U/L, LDH 4 789 U/L, and D-dimer 51.19 mg/L, respectively. It was considered that there was a high possibility of tumor lysis induced by venetoclax, and the drug was immediately stopped. Symptomatic treatments were given, including oxygen inhalation, electrocardiogram monitoring, fluid infusion, alkalinization of urine, and uric acid reduction. The fever of the patient was alleviated on the day of drug withdrawal, the symptoms of chest distress and asthma were improved the next day, and 3 days later, laboratory tests showed serum potassium 4.24 mmol/L, serum calcium 2.02 mmol/L, inorganic phosphate 1.76 mmol/L, serum uric acid 275.0 μmol/L, AST 37 U/L, GGT 80U/L, LDH 1 146 U/L, and D-dimer 7.97 mg/L; venetoclax treatment was resumed and the tumor lysis syndrome-related symptoms did not recur.
