eMedicine Specialties > Oncology > Special Topics in Oncology

Tumor Lysis Syndrome: Follow-up

Author: Koyamangalath Krishnan, MD, FRCP, FACP, Dishner Endowed Chair of Excellence in Medicine, Professor of Medicine and Chief of Hematology-Oncology, Program Director, Hematology-Oncology Fellowship, James H Quillen College of Medicine at East Tennessee State University
Coauthor(s): Ahmad Hammad, MD, Clinical Assistant Professor, Department of Internal Medicine, Division of Hematology/Oncology, East Tennessee State University, James H Quillen Veterans Affairs Medical Center
Contributor Information and Disclosures

Updated: Mar 11, 2009

Follow-up

Further Inpatient Care

Please refer to Medical Care.

Inpatient & Outpatient Medications

Please refer to Medical Care.

Deterrence/Prevention

Patients without laboratory evidence of tumor lysis syndrome who remain at high risk should have prophylactic measures begun 24-48 hours prior to initiation of cytotoxic therapy. Prophylactic measures include liberal intravenous fluid administration, allopurinol, and urinary alkalinization. Close monitoring of fluid status and blood chemistry is important and should continue until 48-72 hours after chemotherapy initiation. Please refer to Medical Care for more information.

Complications

  • Potential complications include uremia and oliguric renal failure due to tubule precipitation of uric acid, calcium phosphate, or hypoxanthine.
  • Severe electrolyte disturbances, such as hyperkalemia and hypocalcemia, predispose patients to cardiac arrhythmia.
  • Iatrogenic complications, such as pulmonary edema from overly vigorous hydration or metabolic alkalosis from excess exogenous administration of bicarbonate, can also occur and are life threatening if not immediately addressed.
 


More on Tumor Lysis Syndrome

Overview: Tumor Lysis Syndrome
Differential Diagnoses & Workup: Tumor Lysis Syndrome
Treatment & Medication: Tumor Lysis Syndrome
Follow-up: Tumor Lysis Syndrome
References
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References

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Further Reading

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Keywords

tumor lysis syndrome, TLS, acute tumor lysis syndrome, ATLS, hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, acute renal failure, ARF, malignancy-associated hyperuricemia, acute leukemia, non-Hodgkin lymphoma, Burkitt lymphoma, Burkitt's lymphoma, malignancy, anticancer treatment, cancer treatment, acute hyperphosphatemia, cardiac arrhythmia, metabolic acidosis, rapid tumor cell turnover, metabolic derangements, rapid cell lysis

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Contributor Information and Disclosures

Author

Koyamangalath Krishnan, MD, FRCP, FACP, Dishner Endowed Chair of Excellence in Medicine, Professor of Medicine and Chief of Hematology-Oncology, Program Director, Hematology-Oncology Fellowship, James H Quillen College of Medicine at East Tennessee State University
Koyamangalath Krishnan, MD, FRCP, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Society of Hematology, and Royal College of Physicians
Disclosure: Nothing to disclose.

Coauthor(s)

Ahmad Hammad, MD, Clinical Assistant Professor, Department of Internal Medicine, Division of Hematology/Oncology, East Tennessee State University, James H Quillen Veterans Affairs Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Philip Schulman, MD, Chief, Medical Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center; Clinical Professor, Department of Medicine, New York University School of Medicine
Philip Schulman, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, American Society of Hematology, and Medical Society of the State of New York
Disclosure: celgene Honoraria Speaking and teaching; Amgen Honoraria Speaking and teaching; genetech/idec Honoraria Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Rajalaxmi McKenna, MD, FACP, Consulting Staff, Department of Medicine, Southwest Medical Consultants, SC, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

Jules E Harris, MD, Clinical Professor of Medicine, Division of Hematology/Medical Oncology, Department of Internal Medicine, University of Arizona College of Medicine at Tucson; Consulting Staff, Arizona Cancer Center
Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Society of Hematology, and Central Society for Clinical Research
Disclosure: GlobeImmune Salary Consulting; Amplimed Consulting fee Consulting

 
 
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