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Sevelamer Hydrochloride for Tumor Lysis Syndrome-related Hyperphosphatemia. BACKGROUND: Tumour lysis syndrome is associated with high levels of uric acid, phosphate and potassium along with low levels of calcium and abnormal renal function. Sevelamer, an oral phosphate-binder is used in the treatment of hyperphosphatemia in children and adults on hemodialysis. CASE CHARACTERISTICS: Two children with T-cell acute lymphoblastic leukemia who presented with a high tumour load and developed tumour lysis syndrome. OBSERVATION: Both children received Rasburicase and Sevelamer hydrochloride. The serum phosphate reduced to normal levels within 24-48 hrs of initiation of sevelamer hydrochloride. MESSAGE: Sevelamer appears to be an effective treatment for hyperphosphatemia associated with tumour lysis syndrome.