Asystole during combination chemotherapy for non-Hodgkin's lymphoma: the acute tumor lysis syndrome

The acute tumor lysis syndrome is a rare condition that has most frequently been documented in patients with rapidly dividing myeloproliferative and l ymphoproliferative malignancies. It is characterized by the development of hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, acute renal f ailure and metabolic acidosis, as a result of massive tumor cell destructio n, usually secondary to effective cytotoxic treatment. We want to present t he case history of a 62-year-old woman who died from cardiorespiratory arre st during combination chemotherapy for non-Hodgkin's lymphoma due to acute tumor lysis syndrome. Despite general preventive measures, severe electroly te abnormalities developed within 18 h of the start of chemotherapy. The ge neral guidelines for the management of this potentially fatal oncologic eme rgency are discussed, with special emphasis on the pathogenetic mechanisms and risk factors in our patient. (C) 2000 Elsevier Science BN. All rights r eserved.