Tumor Lysis Syndrome

An acute, life-threatening condition that appears within 7 days of starting cytotoxic therapies in high-burden, rapidly growing & chemosensitive malignancy like Burkitt's lymphoma & ALL but can also spontaneously (before any treatments) occur in high grade lymphoma & Acute leukemia (both ALL and AML) and solid malignancies

Treatments:

 • IV fluids (up to 5-6L/day)

 • For hyperkalemia, treat with Ca only if EKG changes, otherwise treat with "hyperkalemia cocktail"

 • For hyperuricemia: Renally—dosed Allopurinol.  If uric acid > 10 mg/dl, treat with Rasburicase (6mg)

Key Points:

 • These patients decompensate much quicker than you would think!

 • Aggressive hydration & make sure they have adequate UOP



By Walid Malki, MD, MS @wandering_er



#Tumor #Lysis #Syndrome #TLS #oncology #management #UricAcid