Tumour Lysis Syndrome
Also written as TLS.
Tumour lysis syndrome (TLS) prophylaxis – start aggressive IV hydration (target urine output ≥ 80 ml/h); give allopurinol or rasburicase (if high uric acid) before chemotherapy.
Treatment at a glance
- Aggressive IV hydration
- Allopurinol (or rasburicase) to lower urate
What our notes say
- Tumour lysis syndrome (TLS) prophylaxis – start aggressive IV hydration (target urine output ≥ 80 ml/h); give allopurinol or rasburicase (if high uric acid) before chemotherapy. (Leukaemias)
- Tumour lysis syndrome – acute renal failure, electrolyte disturbances; mitigated by prophylaxis. (Leukaemias)
- | Tumour lysis syndrome | Early cycles | Rising uric acid, hyper‑K, falling Ca | Aggressive hydration, uric acid‑lowering agents, electrolyte correction | (Lymphomas)
- *Answer:* Start aggressive IV hydration and allopurinol to prevent tumour lysis syndrome, and give prophylactic TMP‑SMX for PCP because of impending immunosuppression. (Lymphomas)
- Burkitt lymphoma: short, intensive multi-agent chemotherapy; the fastest-growing human tumour, so start treatment urgently and prevent tumour lysis syndrome (hydration, allopurinol or rasburicase, monitoring of potassium, phosphate, calcium and creatinine). (Lymphomas: Hodgkin and non-Hodgkin lymphoma)
- Tumour lysis syndrome: hyperkalaemia, hyperphosphataemia, hypocalcaemia, hyperuricaemia and acute kidney injury. (Lymphomas: Hodgkin and non-Hodgkin lymphoma)