[Tumor lysis syndrome]. 2010

Takeshi Hagino
Division of Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine.

Tumor lysis syndrome(TLS)is a serious complication of anti-cancer chemotherapy due to the spontaneous or therapyrelated rapid lysis of malignant cells. TLS is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, which result in acute renal failure and metabolic acidosis. Factors predisposing to the development of TLS include a higher growth rate of cancerous cells, a higher sensitivity to chemotherapy, impaired renal function before chemotherapy, elevated lactate dehydrogenase and uric acid serum levels, and a large tumor burden such as huge mass formation and extensive bone marrow involvement. Patients with TLS should be treated carefully with proper fluid management, urinary alkalization, correction of acidosis and electrolyte unbalance, inhibition of the formation of uric acid or destruction of the already circulating uric acid molecules, and a reduction of chemotherapy intensity. Furthermore, the recombinant urate oxidase(rasburicase)significantly reduces the morbidity and mortality of TLS. Patients with malignant tumors must be treated with the knowledge that the proper management prior to chemotherapy, an early diagnosis, and an early aggressive treatment can prevent the occurrence of TLS.

UI MeSH Term Description Entries
D009369 Neoplasms New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. Benign Neoplasm,Cancer,Malignant Neoplasm,Tumor,Tumors,Benign Neoplasms,Malignancy,Malignant Neoplasms,Neoplasia,Neoplasm,Neoplasms, Benign,Cancers,Malignancies,Neoplasias,Neoplasm, Benign,Neoplasm, Malignant,Neoplasms, Malignant
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D015275 Tumor Lysis Syndrome A syndrome resulting from cytotoxic therapy, occurring generally in aggressive, rapidly proliferating lymphoproliferative disorders. It is characterized by combinations of hyperuricemia, lactic acidosis, hyperkalemia, hyperphosphatemia and hypocalcemia. Tumour Lysis Syndrome,Syndrome, Tumor Lysis,Syndrome, Tumour Lysis,Syndromes, Tumor Lysis,Syndromes, Tumour Lysis,Tumor Lysis Syndromes,Tumour Lysis Syndromes
D017408 Guidelines as Topic Works about a systematic statement of policy rules or principles. Guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by convening expert panels. For guidelines in the field of health care and clinical medicine, PRACTICE GUIDELINES AS TOPIC is available. Guidelines as Topics

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