What happens in tumor lysis syndrome?

What happens in tumor lysis syndrome?

Tumor lysis syndrome refers to the constellation of metabolic disturbances that occurs when large numbers of neoplastic cells are killed rapidly, leading to the release of intracellular ions and metabolic byproducts into the systemic circulation.

Can you survive tumor lysis syndrome?

For patients with acute spontaneous tumor lysis syndrome, inpatient mortality rates exceed 58%. Hyponatremia and hypoalbuminemia at the time of admission are risk factors for increased mortality. For patients that survive the initial episode of tumor lysis, the long-term prognosis remains guarded.

What type of cancer causes tumor lysis syndrome?

Tumor lysis syndrome is most common in patients diagnosed with leukemia who have a very high white blood cell (WBC) count. It can also be seen in high-grade lymphomas, especially after the initiation of aggressive chemotherapy. Other solid tumors that can cause tumor lysis syndrome are hepatoblastoma or neuroblastoma.

What is the treatment for tumor lysis syndrome?

In general, treatment of TLS consists of intensive hydration, stimulation of diuresis, and, more specifically, in the use of allopurinol and rasburicase.

What are the signs and symptoms of tumor lysis syndrome?

Symptoms are generally nonspecific and can include:

  • Nausea with or without vomiting.
  • Lack of appetite and fatigue.
  • Dark urine, reduced urine output, or flank pain.
  • Numbness, seizures, or hallucinations.
  • Muscle cramps and spasms.
  • Heart palpitations.

Who is at risk for tumor lysis syndrome?

TLS most commonly occurs after initiation of cytotoxic chemotherapy in patients with acute lymphoblastic leukemia and high-grade lymphomas like Burkitt’s lymphoma [1,2]. Although rare, it may also be seen with chronic leukemias and solid tumors.

How do you prevent tumor lysis syndrome?

To help prevent TLS, assess patients undergoing chemotherapy for risk factors at baseline and monitor them during and after the start of treatment as ordered. The mainstays of preventive care are hydration and allopurinol and recombinant urate oxidase (rasburicase).

Which drugs cause TLS?

Several chemotherapy agents, including cytarabine, cisplatin, etoposide, and paclitaxel, are associated with TLS.