Defined as a combination of metabolic and electrolyte abnormalities occurring spontaneously or following initiation of cytotoxic treatment in patients with cancer. It is characterized by excessive cell lysis.
Most commonly associated with highly proliferative, bulky, chemosensitive malignancies, such as lymphomas and leukemias.
Laboratory TLS is characterized by a combination of any 2 of hyperuricemia, hyperphosphatemia, hyperkalemia, or hypocalcemia. Clinical TLS is defined as laboratory TLS with either an increased serum creatinine, cardiac arrhythmia, seizure activity, or sudden death.
Identification of high-risk patients and appropriate preventive management significantly reduces the risk of developing the syndrome. Vigorous hydration in combination with hypouricemic agents constitutes the cornerstone of both prevention and treatment.
Tumor lysis syndrome (TLS) is defined as a combination of metabolic and electrolyte abnormalities that occurs in patients with cancer, usually after the initiation of cytotoxic treatment but also spontaneously. It is characterized by excessive cell lysis resulting in hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia. TLS is most common with lymphomas and leukemias, in particular Burkitt lymphoma and acute lymphoblastic leukemia. It is also associated with other hematologic malignancies and solid tumors.
History and exam
Clinical Professor of Medicine
University of Colorado
TM declares that he has no competing interests.
Dr Tariq Mughal would like to gratefully acknowledge Dr James Larkin and Dr Anastasia Constantinidou, previous contributors to this monograph. JL and AC declare that they have no competing interests.
Professor of Medicine and Oncology
University of Toronto
SE declares that he has no competing interests.
Consultant Clinical Oncologist
Guy's & St. Thomas' NHS Trust
Honorary Senior Lecturer
Imaging Sciences Division
King's College Hospital
DL declares that he has no competing interests.
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