Hyperuricemia in pediatric malignancies before treatment

The objective of this study was to clarify the prevalence and characteristics of hyperuricemia in various pediatric malignancies before the initiation of treatment. We conducted a retrospective analysis of 119 children with various newly diagnosed malignancies between April 2000 and March 2010. On the basis of the reference values previously established in our laboratory, hyperuricemia was defined as uric acid (UA) levels above 2 standard deviations (s.d.) over the mean values at each age. Thirty-six patients (30.3%) showed hyperuricemia. Hyperuricemia was more common in male patients (36.8%) than in female patients (21.6%). The prevalence of hyperuricemia was highest in patients with lymphoma followed by those with acute lymphoblastic leukemia (ALL). When the study population was divided into hyperuricemia-negative and -positive populations, blood urea nitrogen, creatinine, and lactate dehydrogenase levels, and white blood cell counts (only in leukemia) were found to be significantly higher in the latter group by a univariate analysis. This study highlights useful information for identifying patients with malignancies at risk for tumor lysis syndrome (TLS) before starting chemotherapy.