Tumour lysis syndrome (TLS) is an oncologic emergency that most often occurs following initiation of cytotoxic therapy, especially in patients with acute lymphoblastic leukemia (ALL). Lysis of tumour cells results in the release of large amounts of potassium, phosphate, and nucleic acids. Nucleic acids are catabolized into uric acid, which leads to hyperuricemia. Excess uric acid excretion can precipitate in the renal tubules and lead to acute kidney injury (AKI) through decreased renal blood blow and inflammation. Excess phosphate can also lead to AKI through calcium phosphate deposition in the renal tubules.
- Metabolic abnormalities (hyperkalemia, hyperphosphatemia, hpyocalcemia)
- Nausea + Vomiting
- Heart failure
- Cardiac dysrhythmias
- Muscle cramps
Treatment for TLS relies on risk stratification based on tumour-related factors and patient-related factors.
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