SPONTANEOUS ACUTE TUMOR LYSIS SYNDROME IN ACUTE MYELOID-LEUKEMIA - A SINGLE-CASE REPORT WITH DISCUSSION OF THE LITERATURE

Acute tumor lysis syndrome (ATLS), a condition which results from a ra pid destruction of tumor cells with massive release of cellular breakd own products, has been well described following the treatment of vario us malignancies. However, only a handful of cases of spontaneous ATLS have been reported in the literature. We describe the first reported c ase of spontaneous ATLS in acute myeloid leukemia (AML); A previously healthy 63 year old woman presented with a two month history of fatigu e and a one week history of easy bruising. On admission she had oligur ic acute renal failure, with marked elevation in serum uric acid and p hosphate. A bone marrow biopsy showed AML M7 with fibrosis. The renal failure resolved with supportive care and institution of allopurinol t herapy. Following this, AML induction chemotherapy resulted in complet e remission. Her biochemical and clinical course were very similar to the classical ATLS seen in patients after chemotherapy. Therefore, thi s case represents a rare instance of acute renal failure from spontane ous ATLS, and in our opinion the first reported occurrence of spontane ous ATLS associated with AML.