Tumor Lysis Syndrome - Workup and Management



Initial workup: BMP, Serum uric acid, LDH, Urine output, Consider urinary uric acid : creatinine ratio



Laboratory changes:

 • Uric acid ≥ 8 mg/dL

 • Potassium ≥ 6 mEq/L

 • Phosphorus ≥ 4.5 mg/dL

 • Calcium ≤ 7 mg/dL

 • OR 25 % change in baseline in any of the above



Treatment of Clinical TLS:

 • IV fluids

 • Rasburicase

 • Treat electrolyte abnormalities

 • Cardiac monitoring

 • Consider ICU transfer

 • Tumor lysis kbs every 4-6 hrs

 • Dialysis last resort



Matthew Ho, MD PhD @MatthewHoMD



#TLS #Tumor #Lysis #Syndrome #diagnosis #management #oncology