Our experience with tumor lysis syndrome treatment

Tumor lysis syndrome (TLS) is caused by rapid tumor cell turnover resulting in a release of intracellular contents into the circulation, and subsequent numerous metabolic derangements (hyperkalemia, hypocalcemia, hyperphosphatemia, hyperuricemia). More than 90% of cases have laboratory manifestations, and only about 10% have clinical manifestations. The main complications are acute renal failure, cardiac arrhythmia and metabolic acidosis. The management of TLS consists of preventive measures in high-risk patients prior to cancer treatment as well as prompt initiation of supportive care for patients who develop acute tumor lysis syndrome during treatment. The traditional management consists of intravenous hydratation, urinary alkalinization, diuretics and control of hyperuricemia, electrolyte disturbances and dialysis if needed. The use of a new hypouricemic agent (rasburicase) in patients with TLS minimized the need for renal dialysis as well as reduced the incidence of complications seen in hyperproduction of uric acid to minimum (Tab. 4, Ref. 8). Full Text (Free, PDF) www.bmj.sk.