During chemotherapy for leukemia, which analyte would most likely be elevated in the blood?

During chemotherapy for leukemia, which analyte would most likely be elevated in the blood?

• A. Uric acid
• B. Urea
• C. Creatinine
• D. Ammonia

Answer: (A)

Rapid tumor cell breakdown during chemotherapy releases large amounts of intracellular nucleic acids. Those nucleic acids are metabolized to uric acid, so blood levels of uric acid rise quickly. This scenario is classic for tumor lysis syndrome, a complication often seen when treating rapidly dividing cancers like leukemia. Elevated uric acid can crystallize in the kidneys and cause nephropathy, which is why prevention with hydration and uric acid–lowering therapy is important. Urea and creatinine reflect kidney filtration and overall renal function, so they may rise if kidney injury develops but are not the immediate hallmark of tumor lysis. Ammonia levels relate more to liver metabolism and gut flora activity, not to the rapid cell lysis seen in this context.

Rapid tumor cell breakdown during chemotherapy releases large amounts of intracellular nucleic acids. Those nucleic acids are metabolized to uric acid, so blood levels of uric acid rise quickly. This scenario is classic for tumor lysis syndrome, a complication often seen when treating rapidly dividing cancers like leukemia. Elevated uric acid can crystallize in the kidneys and cause nephropathy, which is why prevention with hydration and uric acid–lowering therapy is important.

Urea and creatinine reflect kidney filtration and overall renal function, so they may rise if kidney injury develops but are not the immediate hallmark of tumor lysis. Ammonia levels relate more to liver metabolism and gut flora activity, not to the rapid cell lysis seen in this context.