Malignancy-induced lactic acidosis in adult lymphoma .
Malignancy-induced lactic acidosis in adult lymphoma
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Clin Nephrol. 2020 Jun 26;:
Authors: Duriseti P, Moreno Vanegas Y, Jaber BL, Balakrishnan VS, Madias NE
Abstract
Malignancy-induced lactic acidosis (MILA), a rare paraneoplastic phenomenon, is mostly described with hematologic malignancies (lymphomas and leukemias) but has also been reported with solid tumors. It is a subset of type B lactic acidosis being mediated without evidence of tissue hypoperfusion. Lymphoma-induced lactic acidosis is often considered an oncologic emergency and is associated with an increased risk of mortality and poor prognosis. It has a complex pathophysiology centered in the "Warburg effect," i.e., the programming of cancer cells to depend on aerobic glycolysis for promotion of their proliferation and anabolic growth. The treatment of lymphoma-induced lactic acidosis is focused on prompt administration of chemotherapy. The role of alkali therapy in this setting is controversial and has limited proven benefit with a potential for worsening the lactic acidosis. If alkali therapy is used in the presence of severe acidemia to optimize cardiovascular status, it should be administered judiciously.
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PMID: 32589134 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Duriseti P, Moreno Vanegas Y, Jaber BL, Balakrishnan VS, Madias NE Tags: Clin Nephrol Source Type: research
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