Leukemia and uric acid: What is the link between them?

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Uric acid levels may be elevated in people with leukemia. When a high number of cancer cells die fast, substantial levels of uric acid are released into the circulation, which the kidneys are unable to remove quickly enough.

Chemotherapy for leukemia or some leukemias with tumors with a fast rate of proliferating cells might cause cancer cells to die quickly and cause excessive amounts of uric acid in the body.

Hyperuricemia is the medical term for excessive uric acid levels in the blood. Hyperuricemia can lead to consequences if left untreated.

This article examines the relationship between uric acid and leukemia, as well as normal and high uric acid levels and ways for decreasing them.

People with leukemia

Uric acid levels may be greater in people with leukemia. This might be a result of a leukemia adverse effect or a therapy side effect.

Cancer cells that break down excessively quickly in a short amount of time, according to the Canadian Cancer Society (CCS), release large levels of toxins into the circulation. Uric acid is one of them.

The kidneys are unable to respond quickly enough to growing uric acid levels, leading blood levels to rapidly rise.

Tumor lysis syndrome is a term used by doctors to describe a disorder caused by high uric acid levels (TLS).

According to a 2017 study, persons with acute leukemia or high-grade lymphoma are more likely to acquire TLS owing to malignancies that divide cells quickly.

TLS is exacerbated by dehydration and existing renal issues.

TLS can also be caused by chemotherapy and other therapies, such as:

Individuals with a higher white blood cell count before starting leukemia therapy may be at a higher risk of getting TLS.

Levels of uric acid

Normal uric acid levels in the blood vary from 2.4 to 6.0 milligrams per deciliter (mg/dl) in females and 3.4 to 7.0 mg/dl in males, according to study published in 2021.

Uric acid levels exceeding 6.8 mg/dl are considered high. Hyperuricemia occurs when uric acid levels in the blood exceed 6.0 mg/dl in females and 7.0 mg/dl in males.

Uric acid levels are greater in those with acute myeloid leukemia (AML), according to researchers from a 2016 study. They discovered that those with AML had an average uric acid level of 4.8 mg/dl.

Uric acid levels and the outlook for leukemia people

Gout is a condition in which the body’s uric acid levels are too high, causing swelling and inflammation in the joints.

According to the Leukemia & Lymphoma Society, people with TLS have extremely high uric acid levels, which can harm the heart and kidneys.

If TLS is not addressed, people may be at risk of developing:

Allopurinol and rasburicase, for example, can help avoid or lessen the risk of TLS problems.

According to a 2016 study, greater levels of uric acid are linked to worse results in people with AML.

Can leukemia patients reduce uric acid levels?

People with leukemia and high uric acid levels may be given intravenous (IV) fluids, which are injected directly into a vein and into the circulation to ensure that the body has enough fluid to wash out the excess uric acid.

Extra fluids may be given 24–48 hours before cancer treatment and in the days after treatment, according to the CCS.

Doctors will keep track of uric acid levels as well as the amount of urine a person produces. An individual must generate 150–200 milliliters of urine every hour to reduce the risk of TLS.

If a person does not produce enough urine or does not sustain adequate urine output, doctors may prescribe a diuretic.

To help the kidneys eliminate uric acid from the body, doctors may use sodium bicarbonate or acetazolamide with IV fluids to avoid uric acid crystallization.

Other medications can also help reduce uric acid levels. Rasburicase breaks down uric acid so the body can wash it out more quickly, while allopurinol inhibits the body from producing it.

Doctors may utilize these strategies to treat TLS, and uric acid levels will be closely monitored during treatment.

Is uric acid linked to an increased risk of cancer?

The data on whether high uric acid levels raise the risk of cancer is conflicting.

High uric acid levels, according to a 2018 research, are a hallmark of chronic inflammation and may raise the risk of cancer. Uric acid, on the other hand, contains antioxidant qualities that may help protect against cancer.

The study’s authors conclude that elevated uric acid levels are associated with a slight increase in cancer risk, however the risk is not statistically significant.

A research published in 2021 found no conclusive evidence of a relationship between high uric acid levels and cancer risk, but did discover a possible danger of malignant cells. This, however, requires additional investigation.

Increased uric acid levels can be caused by a number of reasons, including:

  • a diet high in purines, which are present in alcohol and foods such as seafood and organ meats
  • alcohol consumption
  • obesity
  • high blood pressure

Conclusion

Uric acid levels may be raised in people with leukemia. When a high number of cancer cells die quickly and in a short period of time, this can happen. Uric acid is released into the circulation when cancer cells die.

As a result, the kidneys are unable to remove uric acid at a fast enough rate, resulting in higher uric acid levels in the body.

High amounts of uric acid, if left untreated, can lead to problems and harm internal organs.

To assist the body flush out excess uric acid, people may need uric acid-lowering medicines, diuretics, or IV fluids.

Sources

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688348/
  • https://www.lls.org/myeloproliferative-neoplasms/myelofibrosis/disease-complications
  • https://journals.lww.com/eurjcancerprev/Abstract/2018/07000/Serum_uric_acid_and_cancer_mortality_and.17.aspx
  • https://www.wjnu.org/index.php/wjnu/article/view/424/362
  • https://www.frontiersin.org/articles/10.3389/fgene.2021.608311/full
  • https://www.bloodresearch.or.kr/journal/view.html?uid=1563&vmd=Full
  • https://www.lls.org/leukemia
  • https://www.lls.org/lymphoma
  • https://www.medicalnewstoday.com/articles/uric-acid-and-leukemia
  • https://www.sciencedirect.com/science/article/pii/S0167527315303429
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378935/#B28
  • https://cancer.ca/en/treatments/side-effects/tumour-lysis-syndrome
  • https://ar.iiarjournals.org/content/33/9/3947