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Related Experiment Video

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Electrochemotherapy of Tumours
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Tumour lysis syndrome.

Jose Manuel Calvo Villas1

  • 1Servicio de Hematología y Hemoterapia, Hospital Universitario Miguel Servet, Zaragoza, España.

Medicina Clinica
|January 8, 2019
PubMed
Summary

Tumour lysis syndrome (TLS) is a critical condition causing metabolic derangements and acute kidney injury. Early risk assessment and prophylactic strategies are crucial for managing TLS in cancer patients.

Area of Science:

  • Oncology
  • Nephrology
  • Critical Care Medicine

Background:

  • Tumour lysis syndrome (TLS) is a life-threatening oncologic emergency.
  • It is characterized by massive cancer cell lysis, releasing intracellular contents into circulation.
  • TLS leads to severe metabolic abnormalities, including hyperuricaemia, hyperkalaemia, hyperphosphataemia, and hypocalcaemia, often resulting in acute kidney injury.

Purpose of the Study:

  • To highlight the critical nature of TLS in patients undergoing anti-tumoural therapy.
  • To emphasize the importance of risk stratification for early diagnosis and intervention.
  • To outline current management strategies for TLS, focusing on prophylaxis and supportive care.

Main Methods:

  • Review of current literature and clinical guidelines on TLS.
Keywords:
Acute renal failureInsuficiencia renal agudaRasburicasaRasburicaseSíndrome de lisis tumoralTumour lysis syndrome

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  • Analysis of the pathophysiology and clinical manifestations of TLS.
  • Discussion of risk assessment tools and prophylactic measures.
  • Evaluation of treatment options, including medical management and renal replacement therapy.

    • Main Results:

    • TLS is associated with hematologic malignancies and advanced solid tumours, particularly after cytotoxic therapy.
    • Laboratory derangements are key indicators of TLS and contribute to renal dysfunction.
    • Risk-adapted prophylactic strategies are essential for preventing metabolic alterations and preserving renal function.

    Conclusions:

    • Early identification of patients at risk for TLS is paramount.
    • Prophylaxis is the cornerstone of TLS management, requiring a risk-adapted approach.
    • Multidisciplinary care and consideration of renal replacement therapy are vital for managing high-risk patients and established TLS.