Tumor lysis syndrome in a case of chronic lymphocytic leukemia induced by high-dose corticosteroids (original) (raw)

TUMOR LYSIS SYNDROME: ETIOLOGIES, PATIENT PROFILE, MANAGEMENT AND THERAPY (Atena Editora)

TUMOR LYSIS SYNDROME: ETIOLOGIES, PATIENT PROFILE, MANAGEMENT AND THERAPY (Atena Editora), 2024

Introduction: Tumor lysis syndrome (TLS) is an oncological emergency caused by the massive disintegration of tumor cells and the abrupt release of intracellular contents, such as potassium, phosphate and nucleic acid, into the bloodstream. Objectives: To present the main concepts of SLT, focusing on its etiologies, patient profile, management and therapy. Methodology: A narrative review of the literature was carried out based on 24 articles, which varied between 2016 and 2023. Results: TLS is an underreported oncological emergency that occurs after initiation of treatment for hematological malignancies. As etiologies, we can mainly mention chemotherapy. Its main risk factors include tumor characteristics such as metastatic disease and high proliferation rate. The pathophysiology directly correlates with the clinical picture, as it results from the release of potassium, phosphorus and nucleic acid ions into the bloodstream. The main manifestation of the disease may be acute kidney injury (AKI), caused by hyperuricemia or precipitation of calcium phosphate. For diagnosis and risk stratification of the syndrome, the Cairo and Bishop criteria are used, consisting of laboratory evaluation and the patient's clinical picture. The management of TLS must begin with the appropriate investigation of the disease by prior identification of the patient's profile and risk factors, looking for signs and symptoms such as weight loss, fever, bleeding and lymph node disease. The main approach is isotonic hydration. Conclusion: TLS is an oncological emergency and can be triggered by chemotherapy and spontaneous cell lysis. The clinical picture of the pathology presents with ARF, cardiac arrhythmias, nausea, vomiting, lethargy and sudden death. Management must be individualized and involves isotonic hydration and urate lowering. In case of refractory AKI, oral phosphate binders, diuretics and emergency hemodialysis can be adopted.

Tumor Lysis Syndrome in Patients with Hematological Malignancies

Journal of Oncology

Tumor lysis syndrome is a metabolic complication that may follow the initiation of cancer therapy. It commonly occurs in hematological malignant patients particularly non-Hodgkin’s lymphoma and acute leukemia due to chemotherapy or spontaneously. It is characterized by a biochemical abnormality such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia and its clinical outcome is directly related to these biochemical abnormalities. Prevention and treatment of tumor lysis syndrome depend on immediate recognition of patients at risk. Therefore, identifying patients at risk and prophylactic measures are important to minimize the clinical consequences of tumor lysis syndrome. Patients with low risk should receive hydration and allopurinol. On the other hand patients with high risk should receive hydration and rasburicase in an inpatient setting. It is important to start therapy immediately, to correct all parameters before cancer treatment, to assess risk level of patients...