Factors Associated with the Development of Tumor Lysis Syndrome Among Pediatric Cancer Patients at the Philippine Children&rsquo;s Medical Center

Maria Carmela Gabrielle  L. Tingne,; Anne Lolita    B. Tomas – Abadilla,; Maria Beatriz    P. Gepte,

Factors Associated with the Development of Tumor Lysis Syndrome Among Pediatric Cancer Patients at the Philippine Children’s Medical Center

Maria Carmela Gabrielle L. Tingne | Anne Lolita B. Tomas – Abadilla | Maria Beatriz P. Gepte

Abstract:

BACKGROUND: Tumor lysis syndrome (TLS) is an oncologic emergency resulting from cancer chemotherapy; delays in its recognition could be life-threatening. Early recognition of associated risk factors and its management may help prevent its occurence. OBJECTIVES: To identify the risk factors for TLS among cancer patients at the Philippine Children’s Medical Center. METHODS: This was a retrospective case-control study. Categorical variables were compared using chi-square test and continuous variables were compared using independent t-test. The association between TLS and patients’ characteristics was determined through logistic regression analysis. RESULTS: Medical records of 712 patients with cancer seen between 2016-2020 were reviewed. Children with (n=35) and without (n=137) TLS were selected as cases and controls and matched for age and cancer type. Factors associated with TLS are underweight patients with BMI < 18.5 (cOR 0.33, 95% CI 0.11-0.98); patients with both hepatomegaly and splenomegaly were four times more likely to develop TLS (cOR 3.946, 95% CI 1.2-12.94) while patients with lymphadenopathy were twice more likely to develop TLS (cOR 2.309, 95% CI 1.02-5.21). Patients with elevated WBC, low phosphorus and high uric acid at baseline have increased odds of developing TLS. CONCLUSIONS: After group matching for age and cancer type, factors associated with increased odds of TLS among pediatric cancer patients in PCMC are hepatosplenomegaly, lymphadenopathy, elevated WBC, low potassium level, low phosphorus and high uric acid at baseline with higher fluid balance.

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