Tumor Lysis Syndrome Questions & Answers

Updated: Dec 07, 2018
  • Author: Alan K Ikeda, MD; Chief Editor: Wafik S El-Deiry, MD, PhD  more...
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Questions & Answers

Overview

What is tumor lysis syndrome (TLS)?

When does tumor lysis syndrome (TLS) arise?

Which tumors are associated with tumor lysis syndrome (TLS)?

What is the approach to management of tumor lysis syndrome (TLS)?

What is the pathophysiology of tumor lysis syndrome (TLS)?

What is the pathogenesis of hyperuricemia in tumor lysis syndrome (TLS)?

What is the pathogenesis of acute kidney injury (AKI) in tumor lysis syndrome (TLS)?

What causes tumor lysis syndrome (TLS)?

Which patients are at the highest risk for tumor lysis syndrome (TLS)?

What is the classification of cancers for the risk of tumor lysis syndrome (TLS)?

Which agents may cause tumor lysis syndrome (TLS)?

Which clinical conditions are rare causes of tumor lysis syndrome (TLS)?

What is the global incidence of tumor lysis syndrome (TLS)?

How does the incidence of tumor lysis syndrome (TLS) vary by age?

How is tumor lysis syndrome (TLS) prevented?

What are potential complications of tumor lysis syndrome (TLS)?

What causes cardiac arrhythmia and seizures in tumor lysis syndrome (TLS)?

What iatrogenic complications may occur with tumor lysis syndrome (TLS)?

What is the prognosis of acute kidney injury (AKI) in tumor lysis syndrome (TLS)?

What is the prognosis of cardiac arrhythmia in tumor lysis syndrome (TLS)?

What is the prognosis of metabolic acidosis in tumor lysis syndrome (TLS)?

Presentation

What should be the focus of clinical history in the evaluation of tumor lysis syndrome (TLS)?

What are manifestations of tumor lysis syndrome?

What are symptoms of hyperkalemia in tumor lysis syndrome (TLS)?

What are the signs and symptoms of severe hypocalcemia in tumor lysis syndrome (TLS)?

What are the signs and symptoms of calcium phosphate deposition in tumor lysis syndrome (TLS)?

What are the signs and symptoms of uremia relative to in tumor lysis syndrome (TLS)?

DDX

What are diagnostic considerations for tumor lysis syndrome (TLS)?

Which renal parenchymal disorders should be considered in the differential diagnoses of tumor lysis syndrome (TLS)?

What etiologic findings help differentiate tumor lysis syndrome (TLS) from other causes of renal failure?

What are the differential diagnoses for Tumor Lysis Syndrome?

Workup

How can patients at risk for tumor lysis syndrome be identified?

What is the role of urine pH and output monitoring in the evaluation of tumor lysis syndrome (TLS)?

What is the role of imaging studies in the workup of tumor lysis syndrome (TLS)?

What is the role of cardiac monitoring in the workup of tumor lysis syndrome (TLS)?

Which histologic findings are characteristic of tumor lysis syndrome (TLS)?

What is the role of blood chemistry in the workup of tumor lysis syndrome (TLS)?

Treatment

How is tumor lysis syndrome (TLS) managed?

What is the role of dietary restrictions in the management of tumor lysis syndrome?

What consultations are recommended for the treatment of tumor lysis syndrome (TLS)?

What is included in surveillance for the prevention of tumor lysis syndrome (SLS)?

What should be monitored on a daily basis in patients with tumor lysis syndrome (TLS)?

What is the role of allopurinol in the management of tumor lysis syndrome (TLS)?

What is the role of rasburicase (recombinant urate oxidase) in the management of tumor lysis syndrome (TLS)?

What is the role of febuxostat (Uloric) in the management of tumor lysis syndrome (TLS)?

How is hydration maintained in the prevention of tumor lysis syndrome (TLS)?

What is the role of diuresis for the treatment of tumor lysis syndrome?

What is the role of alkaline therapy in the treatment of tumor lysis syndrome (TLS)?

How is hyperkalemia managed in tumor lysis syndrome (TLS)?

How are hyperphosphatemia and hypocalcemia managed in tumor lysis syndrome (TLS)?

What is the role of dialysis in the treatment of tumor lysis syndrome (TLS)?

What are the National Comprehensive Cancer Network (NCCN) recommendations for management of tumor lysis syndrome (TLS)?

What are the NCCN recommendations for use of rasburicase in the treatment of tumor lysis syndrome (TLS)?

What are the risk factors for tumor lysis syndrome (TLS)?

What is the NCCN recommended dosage for rasburicase for the treatment of tumor lysis syndrome (TLS)?

What are the British Society for Haematology (BSH) recommendations for prevention of tumor lysis syndrome (TLS)?

What are the British Society for Haematology (BSH) guidelines for the use of rasburicase in the prevention of tumor lysis syndrome (TLS)?

Guidelines

Where can the NCCN treatment guidelines for tumor lysis syndrome (TLS) be found?

Medications

How are medications used in the management of tumor lysis syndrome (TLS)?

Which medications are used in the treatment of tumor lysis syndrome (TLS)?

Which medications in the drug class Antidotes, Other are used in the treatment of Tumor Lysis Syndrome?

Which medications in the drug class Electrolyte Supplements, Parenteral are used in the treatment of Tumor Lysis Syndrome?

Which medications in the drug class Alkalinizing Agents are used in the treatment of Tumor Lysis Syndrome?

Which medications in the drug class Diuretics, Loop are used in the treatment of Tumor Lysis Syndrome?

Which medications in the drug class Electrolytes are used in the treatment of Tumor Lysis Syndrome?

Which medications in the drug class Uricosuric Agents are used in the treatment of Tumor Lysis Syndrome?