Risk Factors Leading to Tumor Lysis Syndrome in Chemotherapy for Multiple Myeloma

Abstract

Risk factors leading to the development of tumor lysis syndrome (TLS) in multiple myeloma chemotherapy are itemized in the TLS guidance, but the specific conditions are not specified. While the introduction of one new drug after another improves the outcome of multiple myeloma treatment with chemotherapy, the risk of TLS is expected to increase, and further clarification of risk factors will be necessary in the future. Therefore, in this study, we retrospectively investigated the occurrence of TLS in the first course of chemotherapy for multiple myeloma in our hospital between January 1, 2020 and December 31, 2022, and examined the risk factors leading to TLS. Univariate analysis results suggest that ISS stage III is a TLS risk factor with a significant difference as indicated in the TLS Guidance. Elevated β2-microglobulin, also a tumor marker for multiple myeloma, is also suggested to be a TLS risk factor in multiple myeloma chemotherapy with significant differences, although this factor is not indicated in the TLS guidance. We report these results here because we believe that they can be used to assess the risk of TLS occurrence in future multiple myeloma chemotherapy and contribute to the development of supportive care used for TLS prevention.