The metabolic derangements and the effectiveness of the supportive treatment to prevent them were analyzed in 18 patients with acute lymphocytic leukemia, and the results are as follows;
1) The frequently observed metabolic derangements were hyperphosphatemia (Pre-Tx : 43.8%, Post-Tx : 30.8%), elevation of LDH level, hyperuricemia, hypocalcemia and hyperkalemia in the descending order.
2) With the supportive treatment to prevent hyperuricemia, there was no full-blown acute tumor lysis syndrome, and even the metabolic derangements were not so severe except in some cases with hyperleukocytosis.
3) The frequency and severity of metabolic derangements were higher in the patients with hyperleukocytosis compared to those without hyperleukocytosis.
4) No case with significant azotemia was observed in the present study.
With the above results we concluded that the supportive treatments were quite effective to prevent metabolic derangements in acute lymphocytic leukemia especially when it is hyperleukocytic, and early detection of leukemia with early initiation of preventive measures for metabolic derangements listed in this study is most important for the prevention of tumor lysis syndrome.
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