A 3-year-old boy develops renal failure from hyperuricemia on the second day of cytosine arabinoside therapy for acute myelogenous leukemia. Which of the following is the most likely cause of his hyperuricemia?

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Quizplus · Accepted Answer

The hyperuricemia is most likely due to tumor lysis syndrome, where rapid cell lysis from chemotherapy leads to increased catabolism of purines from the lysed leukemic cells, resulting in elevated uric acid levels. Chemotherapeutic treatment of leukemias often results in tumor lysis syndrome, TLS. TLS is a severe and potentially life-threatening complication in patients with cancer occurring most frequently as a consequence of chemotherapy, radiotherapy, or immunotherapy. The hyperuricemia associated with TLS is the result of significantly increased catabolism of purine nucleotides in the dying cancer cells. The hyperuricemia can lead to acute uric acid nephropathy and kidney failure.

A 3-Year-Old Boy Develops Renal Failure from Hyperuricemia on the Second