TY - JOUR
T1 - Tumor lysis syndrome
T2 - A systematic review of case series and case reports
AU - Firwana, Belal M.
AU - Hasan, Rim
AU - Hasan, Nour
AU - Alahdab, Fares
AU - Alnahhas, Iyad
AU - Hasan, Seba
AU - Varon, Joseph
PY - 2012/3
Y1 - 2012/3
N2 - Tumor lysis syndrome (TLS) is a clinical condition that is caused by a massive lysis of tumor cells that accumulate very rapidly and disturb hemodynamics. This oncologic emergency requires immediate intervention. Tumor lysis syndrome was first described in the 19th century. Since then, it has become a well-known disease with improved management measures. Tumor lysis syndrome can occur after any type of neoplasm. It is highly associated with rapidly proliferating tumors compared with those that are well demarcated, such as acute lymphoblastic leukemia and high-grade non-Hodgkin lymphoma. Initiation of chemotherapy, radiotherapy, or steroid treatment may trigger TLS, or it may develop spontaneously. The release of massive quantities of intracellular contents may produce hyperkalemia, hyperphosphatemia, secondary hypocalcemia, hyperuricemia, and acute renal failure. Prevention and treatment measures include intravenous hydration, use of allopurinol and rasburicase, management of TLS-associated electrolyte abnormalities, and renal replacement therapy; the use of urine alkalinization remains controversial. In this article, we summarize the findings of case series and case reports published over the past 6 years in an effort to help familiarize clinicians better recognize and manage TLS.
AB - Tumor lysis syndrome (TLS) is a clinical condition that is caused by a massive lysis of tumor cells that accumulate very rapidly and disturb hemodynamics. This oncologic emergency requires immediate intervention. Tumor lysis syndrome was first described in the 19th century. Since then, it has become a well-known disease with improved management measures. Tumor lysis syndrome can occur after any type of neoplasm. It is highly associated with rapidly proliferating tumors compared with those that are well demarcated, such as acute lymphoblastic leukemia and high-grade non-Hodgkin lymphoma. Initiation of chemotherapy, radiotherapy, or steroid treatment may trigger TLS, or it may develop spontaneously. The release of massive quantities of intracellular contents may produce hyperkalemia, hyperphosphatemia, secondary hypocalcemia, hyperuricemia, and acute renal failure. Prevention and treatment measures include intravenous hydration, use of allopurinol and rasburicase, management of TLS-associated electrolyte abnormalities, and renal replacement therapy; the use of urine alkalinization remains controversial. In this article, we summarize the findings of case series and case reports published over the past 6 years in an effort to help familiarize clinicians better recognize and manage TLS.
KW - Allopurinol
KW - Hyperkalemia
KW - Hyperphosphatemia
KW - Kidney failure
KW - Neoplasm
KW - Rasburicase
KW - Tumor lysis syndrome
KW - Uric acid
UR - http://www.scopus.com/inward/record.url?scp=84858858482&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858858482&partnerID=8YFLogxK
U2 - 10.3810/pgm.2012.03.2540
DO - 10.3810/pgm.2012.03.2540
M3 - Review article
C2 - 22437219
AN - SCOPUS:84858858482
SN - 0032-5481
VL - 124
SP - 92
EP - 101
JO - Postgraduate medicine
JF - Postgraduate medicine
IS - 2
ER -