Pre-treatment tumour lysis syndrome and acute renal failure in adult Nigerians with Burkitt's lymphoma: report of three cases and literature review.

Pre-treatment tumour lysis syndrome (pre-TTLS) is not an unusual clinical entity in high-grade lymphomas and lymphoblastic leukaemias. The overall incidence and frequency is unknown and to the best of our knowledge none has been published in Nigeria involving adult females with advanced stage Burkitt's lymphoma (ASBL). Three of the reported cases had pre-TTLS complicated by acute renal failure (ARF). The first two cases had a complete reversal of the ARF with aggressive supportive management and slow introduction of cytotoxic chemotherapy whereas the third case died of ARF due to delay in commencement of aggressive supportive management, chemotherapy and haemodialysis due to financial constraint. This paper stresses the importance of aggressive supportive management and slow introduction of cytotoxic chemotherapy in patients with a stage C and/or stage D Burkitt's lymphoma presenting with pre-TTLS.