Low risk disease (LRD) | Intermediate risk disease (IRD) | High risk disease (HRD) |
Most solid tumors | Rare, highly chemotherapy-sensitive solid tumors (eg, neuroblastoma, germ cell tumor, small-cell lung cancer) with bulky or advanced stage disease | N/A |
MM | Plasma cell leukemia | N/A |
CML | N/A | N/A |
Indolent NHL | N/A | N/A |
HL | N/A | N/A |
CLL and WBC <50 x 109/L treated only with alkylating agents | CLL treated with fludarabine, rituximab, or lenalidomide, or venetoclax and lymph node ≥5 cm or absolute lymphocyte count ≥25 x 109/L, and/or those with high WBC ≥50 x 109/L | CLL treated with venetoclax and lymph node ≥10 cm, or lymph node ≥5 cm and absolute lymphocyte count ≥25 x 109/L and elevated baseline uric acid. |
AML and WBC <25 x 109/L and LDH <2 x ULN | AML with WBC 25 to 100 x 109/L | AML and WBC ≥100 x 109/L |
AML and WBC <25 x 109/L and LDH ≥2 x ULN | ||
Adult intermediate grade NHL and LDH within normal limits | Adult T cell leukemia/lymphoma, diffuse large B-cell, transformed, and mantle cell lymphomas with LDH > ULN, non-bulky | Adult T cell leukemia/lymphoma, diffuse large B-cell, transformed, and mantle cell lymphomas with bulky disease and LDH ≥2 x ULN |
Adult ALCL | Childhood ALCL stage III/IV | N/A |
N/A | Childhood intermediate grade NHL stage III/IV with LDH <2 x ULN | Stage III/IV childhood diffuse large B-cell lymphoma with LDH ≥2 x ULN |
N/A | ALL and WBC <100 x 109/L and LDH <2 x ULN | Burkitt's leukemia |
Other ALL and WBC ≥100 x 109/L and/or LDH ≥2 x ULN | ||
N/A | Burkitt lymphoma and LDH <2 x ULN | Burkitt lymphoma stage III/IV and/or LDH ≥2 x ULN |
N/A | Lymphoblastic lymphoma stage I/II and LDH <2 x ULN | Lymphoblastic lymphoma stage III/IV and/or LDH ≥2 x ULN |
N/A | N/A | Intermediate risk disease with renal dysfunction and/or renal involvement |
Intermediate risk disease with uric acid, potassium, and/or phosphate > ULN | ||
Prophylaxis recommendations | ||
Monitoring | Monitoring | Monitoring |
Hydration | Hydration | Hydration |
±Allopurinol | Allopurinol | Rasburicase* |
Do you want to add Medilib to your home screen?