Tumor Lysis Syndrome

Scott Howard, Ching Hon Pui, Raul C. Ribeiro

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Tumor lysis syndrome (TLS) is a serious, sometimes life-threatening oncologic emergency caused by rapid and massive cellular lysis and subsequent release of tumor cell contents and cytokines into the bloodstream. Clinical consequences of TLS include nausea, vomiting, cardiac dysrhythmias and acute kidney injury resulting from hyperuricemia, hyperphosphatemia, or hyperkalemia, and seizures or other symptoms of hypocalcemia. The main principles of TLS management are the identification of high-risk patients, initiation of preventive therapy, early recognition of potential complications and prompt intervention to prevent or mitigate them. As newer and more effective cytotoxic therapies have been developed to treat both hematologic cancers and solid tumors, the incidence of TLS has increased and emerged in a broader spectrum of patients and malignancies. Thus, it is critical for oncologists, nephrologists and other clinicians to stay abreast of new developments in the prevention and management of TLS. The syndrome is classified with the modified Cairo-Bishop classification and patients are stratified into one of the following categories, according to their a priori risk for clinical TLS: negligible risk, low risk, intermediate risk, high risk and established TLS at presentation. This chapter reviews the pathophysiology, epidemiology, risk stratification and management for each risk group, and includes recommendations for risk-adapted monitoring, intravenous fluids and control of elevated phosphorus and uric acid.

Original languageEnglish (US)
Title of host publicationRenal Disease in Cancer Patients
PublisherElsevier Inc.
Pages39-64
Number of pages26
ISBN (Print)9780124159488
DOIs
StatePublished - Oct 1 2013
Externally publishedYes

Fingerprint

Tumor Lysis Syndrome
Neoplasms
Phosphorus Acids
Hyperphosphatemia
Hyperuricemia
Hyperkalemia
Hypocalcemia
Risk Management
Uric Acid
Acute Kidney Injury
Nausea
Vomiting
Cardiac Arrhythmias
Epidemiology
Seizures
Emergencies
Cytokines

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Dentistry(all)

Cite this

Howard, S., Pui, C. H., & Ribeiro, R. C. (2013). Tumor Lysis Syndrome. In Renal Disease in Cancer Patients (pp. 39-64). Elsevier Inc.. https://doi.org/10.1016/B978-0-12-415948-8.00004-0

Tumor Lysis Syndrome. / Howard, Scott; Pui, Ching Hon; Ribeiro, Raul C.

Renal Disease in Cancer Patients. Elsevier Inc., 2013. p. 39-64.

Research output: Chapter in Book/Report/Conference proceedingChapter

Howard, S, Pui, CH & Ribeiro, RC 2013, Tumor Lysis Syndrome. in Renal Disease in Cancer Patients. Elsevier Inc., pp. 39-64. https://doi.org/10.1016/B978-0-12-415948-8.00004-0
Howard S, Pui CH, Ribeiro RC. Tumor Lysis Syndrome. In Renal Disease in Cancer Patients. Elsevier Inc. 2013. p. 39-64 https://doi.org/10.1016/B978-0-12-415948-8.00004-0
Howard, Scott ; Pui, Ching Hon ; Ribeiro, Raul C. / Tumor Lysis Syndrome. Renal Disease in Cancer Patients. Elsevier Inc., 2013. pp. 39-64
@inbook{0769a7aed06440efa02f7eb5b94dd6ac,
title = "Tumor Lysis Syndrome",
abstract = "Tumor lysis syndrome (TLS) is a serious, sometimes life-threatening oncologic emergency caused by rapid and massive cellular lysis and subsequent release of tumor cell contents and cytokines into the bloodstream. Clinical consequences of TLS include nausea, vomiting, cardiac dysrhythmias and acute kidney injury resulting from hyperuricemia, hyperphosphatemia, or hyperkalemia, and seizures or other symptoms of hypocalcemia. The main principles of TLS management are the identification of high-risk patients, initiation of preventive therapy, early recognition of potential complications and prompt intervention to prevent or mitigate them. As newer and more effective cytotoxic therapies have been developed to treat both hematologic cancers and solid tumors, the incidence of TLS has increased and emerged in a broader spectrum of patients and malignancies. Thus, it is critical for oncologists, nephrologists and other clinicians to stay abreast of new developments in the prevention and management of TLS. The syndrome is classified with the modified Cairo-Bishop classification and patients are stratified into one of the following categories, according to their a priori risk for clinical TLS: negligible risk, low risk, intermediate risk, high risk and established TLS at presentation. This chapter reviews the pathophysiology, epidemiology, risk stratification and management for each risk group, and includes recommendations for risk-adapted monitoring, intravenous fluids and control of elevated phosphorus and uric acid.",
author = "Scott Howard and Pui, {Ching Hon} and Ribeiro, {Raul C.}",
year = "2013",
month = "10",
day = "1",
doi = "10.1016/B978-0-12-415948-8.00004-0",
language = "English (US)",
isbn = "9780124159488",
pages = "39--64",
booktitle = "Renal Disease in Cancer Patients",
publisher = "Elsevier Inc.",
address = "United States",

}

TY - CHAP

T1 - Tumor Lysis Syndrome

AU - Howard, Scott

AU - Pui, Ching Hon

AU - Ribeiro, Raul C.

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Tumor lysis syndrome (TLS) is a serious, sometimes life-threatening oncologic emergency caused by rapid and massive cellular lysis and subsequent release of tumor cell contents and cytokines into the bloodstream. Clinical consequences of TLS include nausea, vomiting, cardiac dysrhythmias and acute kidney injury resulting from hyperuricemia, hyperphosphatemia, or hyperkalemia, and seizures or other symptoms of hypocalcemia. The main principles of TLS management are the identification of high-risk patients, initiation of preventive therapy, early recognition of potential complications and prompt intervention to prevent or mitigate them. As newer and more effective cytotoxic therapies have been developed to treat both hematologic cancers and solid tumors, the incidence of TLS has increased and emerged in a broader spectrum of patients and malignancies. Thus, it is critical for oncologists, nephrologists and other clinicians to stay abreast of new developments in the prevention and management of TLS. The syndrome is classified with the modified Cairo-Bishop classification and patients are stratified into one of the following categories, according to their a priori risk for clinical TLS: negligible risk, low risk, intermediate risk, high risk and established TLS at presentation. This chapter reviews the pathophysiology, epidemiology, risk stratification and management for each risk group, and includes recommendations for risk-adapted monitoring, intravenous fluids and control of elevated phosphorus and uric acid.

AB - Tumor lysis syndrome (TLS) is a serious, sometimes life-threatening oncologic emergency caused by rapid and massive cellular lysis and subsequent release of tumor cell contents and cytokines into the bloodstream. Clinical consequences of TLS include nausea, vomiting, cardiac dysrhythmias and acute kidney injury resulting from hyperuricemia, hyperphosphatemia, or hyperkalemia, and seizures or other symptoms of hypocalcemia. The main principles of TLS management are the identification of high-risk patients, initiation of preventive therapy, early recognition of potential complications and prompt intervention to prevent or mitigate them. As newer and more effective cytotoxic therapies have been developed to treat both hematologic cancers and solid tumors, the incidence of TLS has increased and emerged in a broader spectrum of patients and malignancies. Thus, it is critical for oncologists, nephrologists and other clinicians to stay abreast of new developments in the prevention and management of TLS. The syndrome is classified with the modified Cairo-Bishop classification and patients are stratified into one of the following categories, according to their a priori risk for clinical TLS: negligible risk, low risk, intermediate risk, high risk and established TLS at presentation. This chapter reviews the pathophysiology, epidemiology, risk stratification and management for each risk group, and includes recommendations for risk-adapted monitoring, intravenous fluids and control of elevated phosphorus and uric acid.

UR - http://www.scopus.com/inward/record.url?scp=84902388697&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902388697&partnerID=8YFLogxK

U2 - 10.1016/B978-0-12-415948-8.00004-0

DO - 10.1016/B978-0-12-415948-8.00004-0

M3 - Chapter

SN - 9780124159488

SP - 39

EP - 64

BT - Renal Disease in Cancer Patients

PB - Elsevier Inc.

ER -