Importance of informed consent in offering to return research results to research participants

✍ Scribed by Fernandez, Conrad V. ;Kodish, Eric ;Weijer, Charles

• Publisher: John Wiley and Sons
• Year: 2003
• Tongue: English
• Weight: 42 KB
• Volume: 41
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/mpo.10435

✦ Synopsis

Medical and Pediatric Oncology a Brief Report ''Tumor lysis syndrome (TLS), neuroblastoma (NB), and correlation between serum lactate dehydrogenase (LDH) levels and MYCNamplification,'' reporting on a fatal case of fulminant TLS during induction therapy in a child with high-risk stage 4 NB.

We completely agree with the opinion of these authors, on the need for prophylaxis, with hyperhydration, urine alkalinization, and allopurinol administration. These are needed in order to avoid severe complications due to metabolic alterations secondary to induction chemotherapy (i.e., hyperuricemia, hyperphosphatemia, hypocalcemia, hyperkalemia, and acute renal failure).

We wish to point out that in our experience with more than 100 cases of NB observed in the last 15 years, we have never had a case of fatal tumor lysis syndrome in these patients. Perhaps this is because we have used uricase, a major uricolytic agent currently employed in Italy and many other European countries [2,3]. We therefore suggest that uricase be administered when serum uric acid increases over 6.5 mg/dl in NB patients with very high serum LDH levels, extensive disease and especially liver deposits. Uricase would be added to standard urine alkalinization and allopurinol dosage.

Finally, the recent introduction of the novel drug rasburicase, a promising recombinant form of uricase, promises to be of major clinical benefit in most cases of severe TLS [4,5].