Tumor Lysis Syndrome

Question 1

What is tumor lysis syndrome

Answer 1

A constellation of metabolic disturbances that occur when large numbers of neoplastic cells are killed RAPIDLY leading to release of intracellular ions and metabolic by products into the systemic circulation

Question 2

According to Cairo and Bishop in 2004, Tls is classified into

Answer 2

Lab and clinical Tls

Question 3

Laboratory Tls and values

Answer 3

2 or more of the following occuring 3 days before or 7 days after initiation of chemotherapy
Uric acid >8mg/dl(0.47mmol/L) or 25%increase
Potassium >6mmol or 25%increase
Phosphate >4.5mmol/l or >6.5mmol in children
Calcium <7mg/dl (1.75mmol/l) or 25%decrease

Question 4

Clinical Tls includes

Answer 4

Lab TLS plus one or more of the following
-Cardiac arrythmias
Seizures
Sudden death
Increased serum creatinine(1.5 times normal)
By definition, if Aki is present, then patient meets the definition of TLS

Question 5

Risk factors for Tls depend on

Answer 5

Cancer characteristics
Patient characteristics
Chemotherapy characteristics
High risk malignancies

Question 6

Cancer characteristics for tls tisks

Answer 6

Tumor with high cell turnover and rapid growth rate
High tumor bulk
Pretreatment urate and lactate dehydrogenase
Most common tumors …NHL,ALL,AML,CML.burkitts

Question 7

Patients characteristics for tls risk

Answer 7

Dehydration
Urine pH
Pre existing renal insufficiency