Virtual Medical Centre

Tumour Lysis Syndrome

• What is Tumour Lysis Syndrome?
• Who gets Tumour Lysis Syndrome?
• Predisposing Factors
• Progression
• Probable Outcomes
• How is Tumour Lysis Syndrome Diagnosed?
• How is Tumour Lysis Syndrome treated?
• Tumour Lysis Syndrome References
• Drugs/Products Associated with Tumour Lysis Syndrome

What is Tumour Lysis Syndrome?

Tumour lysis syndrome is the name given to a collection of metabolic abnormalities that occur following the initiation of cytotoxic chemotherapy.

Who gets Tumour Lysis Syndrome?

This potentially lethal syndrome is most likely to occur in patients with bulky, rapidly proliferating tumours that are responsive to therapy. The most common malignancies it is associated with are leukaemias, high-grade non-hodgkin's lymphoma and Burkitt lymphoma, although it has been associated with other haematological and solid malignancies. Clinically, tumour lysis syndrome occurs in about 6% of patients being treated for non-hodgkin's lymphoma, but laboratory parameters consistent with it are seen in up to 42% of patients.

Predisposing Factors

The cells that make up cancer are often numerous and rapidly proliferating. There are therefore large numbers of them to be killed, and chemotherapy aims to do this quickly. As such large numbers are killed at the same time, their contents are rapidly and simultaneously released into the bloodstream. As a result, tumour lysis syndrome may occur and usually does so within 1-5 days of chemotherapy. Very occasionally, tumour lysis syndrome occurs spontaneously, with no exposure to chemotherapy agents.

Progression

Tumour lysis syndrome causes a triad of hyperkalaemia, hyperphosphataemia and hyperuricaemia and leads to acute renal failure.