Tumor lysis syndrome is a group of metabolic abnormalities that can occur as a complication during the treatment of cancer ,  where large amounts of tumor cells are killed off lysed at the same time by the treatment, releasing their contents into the bloodstream. This occurs most commonly after the treatment of lymphomas and leukemias. In oncology and hematology , this is a potentially fatal complication, and patients at increased risk for TLS should be closely monitored before, during, and after their course of chemotherapy. Tumor lysis syndrome is characterized by high blood potassium hyperkalemia , high blood phosphate hyperphosphatemia , low blood calcium hypocalcemia , high blood uric acid hyperuricemia , and higher than normal levels of blood urea nitrogen BUN and other nitrogen-containing compounds azotemia.
Tumor lysis syndrome: a systematic review of case series and case reports
A Patient With Tumor Lysis Syndrome
This case is written by Dr. Tumor Lysis Syndrome is a constellation of metabolic disturbances that can occur as a potentially fatal complication of treating cancers, most notably leukemias or solid rapidly-proliferating tumours. This case highlights the following:. A year-old male presents to the emergency department complaining of general weakness for 2 days. He has been placed in the resuscitation bay. He was recently diagnosed with ALL and had chemotherapy 3 days ago for the first time.
Acute lymphocytic leukemia ALL , also known as acute lymphoblastic leukemia, refers to an abnormal growth of lymphocyte precursors or lymphoblasts. Acute leukemias have large numbers of immature leukocytes and overproduction of cells in the blast stage of maturation. Untreated, acute leukemia is invariably fatal, usually because of complications that result from leukemic cell infiltration of the bone marrow and vital organs.
Tumor lysis syndrome is a metabolic complication that may follow the initiation of cancer therapy. It is characterized by a biochemical abnormality such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia and its clinical outcome is directly related to these biochemical abnormalities. Prevention and treatment of tumor lysis syndrome depend on immediate recognition of patients at risk. Therefore, identifying patients at risk and prophylactic measures are important to minimize the clinical consequences of tumor lysis syndrome. Patients with low risk should receive hydration and allopurinol.