Classification of Tumor Lysis Syndrome (TLS) and Treatment of Metabolic Abnormalities of TLS

Laboratory TLS:

 • Uric acid ≥ 8.0 mg/dL

 • Potassium ≥ 6.0 mEq/dL

 • Phosphorus ≥ 4.6 mg/dL

 • Calcium ≤ 7.0 mg/dL

Clinical TLS:

 • AKI (defined as creatinine > 1.5x the upper limit of normal for patient age and sex)

 • Cardiac arrhythmia

 • Seizure, tetany, or other symptomatic hypocalcemia

Treatment of TLS:

 • Hypovolemia - Intravenous fluids

 • Renal failure - Dialvsis

 • Hyperuricemia - Allopurinol, Rasburicase

 • Hyperphosphatemia - Aluminum hydroxide

 • Hyperkalemia - Standard treatment

 • Hypocalcemia - Calcium gluconate



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