Tumor lysis syndrome: review of pathogenesis, risk factors and management of a medical emergency

Expert Rev Hematol. 2016;9(2):197-208. doi: 10.1586/17474086.2016.1127156. Epub 2016 Jan 8.

Abstract

Tumor lysis syndrome (TLS) is a rare but potentially life-threatening complication of neoplasms, preferentially hematological malignancies. Well known since at least ninety years ago, this condition can be misdiagnosed and incorrectly managed due to rapid onset of symptoms, sometimes overlapping with cancer-derived clinical conditions. Our purpose is to discuss some old and new issues of this syndrome. Predisposing factors as type of malignancy, chemotherapy regimen and age are promptly available and useful tools for inducing TLS suspicion. Management of clinical syndrome requires hydration, fluid balance, electrolytes and hyperuricemia correction, and ultimately dialysis when acute kidney injury is worsening.

Keywords: Tumor lysis syndrome; allopurinol; drug induced; rasburicase.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Disease Management
  • Humans
  • Neoplasms / complications*
  • Neoplasms / diagnosis
  • Neoplasms / drug therapy
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Tumor Lysis Syndrome / diagnosis
  • Tumor Lysis Syndrome / etiology*
  • Tumor Lysis Syndrome / prevention & control
  • Tumor Lysis Syndrome / therapy*