Tumor lysis syndrome causes: Difference between revisions

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__NOTOC__
__NOTOC__
{{Tumor lysis syndrome}}
{{Tumor lysis syndrome}}
{{CMG}}
{{CMG}} {{N.F}}
 
==Overview==
==Overview==
The most common tumors associated with this syndrome are poorly differentiated lymphomas, such as [[Burkitt's lymphoma]], and leukemias, such as [[acute lymphoblastic leukemia]] (ALL) and [[acute myeloid leukemia]] (AML). Other cancers have also been associated with TLS but are less common. Usually, the precipitating medication regimen includes combination [[chemotherapy]], but those patients with lymphoma and ALL can be affected with [[steroid]] treatment alone.
Development of tumor lysis syndrome is the result of initiation of [[chemotherapy]] or [[radiotherapy]] in cancer patients. The most common causes of tumor lysis syndrome are [[Burkitt's lymphoma]][[Acute lymphoblastic leukemia|, acute lymphoblastic leukemia]][[Acute myeloid leukemia|, acute myeloid leukemia]] and [[chemotherapy]] including [[methotrexate]]. Sometimes it can occur spontaneously  without administration of treatment primarily in patients with non-Hodgkin lymphoma (NHL) or acute leukemia.
 
==Causes==
==Causes==
===Life Threatening Causes===
===Common Causes===
===Common Causes===
The most common causes of tumor lysis syndrome are:<ref name="urlwww.asn-online.org">{{cite web |url=https://www.asn-online.org/education/distancelearning/curricula/onco/Chapter4.pdf |title=www.asn-online.org |format= |work= |accessdate=}}</ref><ref name="pmid21561350">{{cite journal |vauthors=Howard SC, Jones DP, Pui CH |title=The tumor lysis syndrome |journal=N. Engl. J. Med. |volume=364 |issue=19 |pages=1844–54 |date=May 2011 |pmid=21561350 |pmc=3437249 |doi=10.1056/NEJMra0904569 |url=}}</ref>
*[[Burkitt's lymphoma]]
*[[Burkitt's lymphoma]]
*[[Acute lymphoblastic leukemia]]
*[[Acute lymphoblastic leukemia]]
*[[Acute myeloid leukemia]]
*[[Acute myeloid leukemia]]
*[[Chemotherapy]]
*[[Chemotherapy]] including [[methotrexate]]
 
=== Less common causes ===
* Solid tumor
* [[Myeloma]]
* [[Chronic leukemia|Chronic myeloid leukemia CML]]
* CLL [[chronic lymphocytic leukemia]]
* [[Hodgkin lymphoma]]
* [[Small lymphocytic lymphoma]]
* [[Marginal zone lymphoma|Marginal zone B cell]]
* [[MALT lymphoma|MALT]]
* Nonblastoid mantle cell
* [[Cutaneous T cell lymphoma|Cutaneous T cell]]
* [[Adult T-cell leukemia]]


===Causes by Organ System===
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
{| style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dental'''
| '''Dental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"|  
| bgcolor="Beige" |  
[[Bortezomib]],
[[Bortezomib]],
[[cytotoxic chemotherapy]],
[[Carfilzomib]],
[[Cytarabine]],
[[Chemotherapy|cytotoxic chemotherapy]],
[[Doxorubicin Hydrochloride]]
[[etoposide]],
[[etoposide]],
[[fludarabine]],
[[fludarabine]],
[[glucocorticoids]],
[[glucocorticoids]],
[[hydroxyurea]],
[[hydroxyurea]],
[[Ibrutinib]],
[[imatinib]],
[[imatinib]],
[[lenalidomide ]],
[[lenalidomide ]] ,
[[Nelarabine]],
[[Nilotinib]],
[[Ofatumumab]],
[[paclitaxel]],
[[paclitaxel]],
[[Pralatrexate]],
[[rituximab]],
[[rituximab]],
[[thalidomide]],
[[Vincristine sulfate liposome]]
[[zoledronic acid]]
[[zoledronic acid]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"|  
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"|  
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| '''Nutritional/Metabolic'''
|bgcolor="Beige"|  
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"|  
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"|  
| bgcolor="Beige" |  
[[Acute lymphoblastic leukemia ]],
[[Acute lymphoblastic leukemia ]] ,
[[acute myeloid leukemia]],
[[acute myeloid leukemia]],
[[adult T-cell leukemia/lymphoma ]],
[[adult T-cell leukemia/lymphoma ]] ,
[[anaplastic large cell lymphoma]],
[[anaplastic large cell lymphoma]],
[[breast cancer ]],
[[breast cancer ]] ,
[[Burkitt's lymphoma]],
[[Burkitt's lymphoma]],
[[chronic myeloid leukemia]],
[[chronic myeloid leukemia]],
[[diffuse large B-cell lymphoma]],
[[diffuse large B-cell lymphoma]],
[[gastrointestinal stromal tumors]],
[[gastrointestinal stromal tumors]],
[[germ cell tumors ]],
[[germ cell tumors ]] ,
[[hepatoblastoma]],
[[hepatoblastoma]],
[[hepatocellular carcinoma]],
[[hepatocellular carcinoma]],
[[hodgkin's disease]],
[[hodgkin's disease]],
[[isolated plasmacytomas]],
[[Plasmacytoma|isolated plasmacytomas]],
[[mantle cell lymphoma]],
[[mantle cell lymphoma]],
[[medulloblastoma]],
[[medulloblastoma]],
[[melanoma]],
[[melanoma]],
[[metastatic colorectal cancer ]],
[[Colorectal cancer|metastatic colorectal cancer]] ,
[[multiple myeloma]],
[[multiple myeloma]],
[[neuroblastoma]],
[[neuroblastoma]],
[[Non-Hodgkin lymphoma]],
[[Non-Hodgkin lymphoma]],
[[ovarian cancer ]],
[[ovarian cancer ]] ,
[[rhabdomyosarcoma]],
[[rhabdomyosarcoma]],
[[sarcoma]],
[[sarcoma]],
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[[Vulvar cancer|squamous cell carcinoma of the vulva]],
[[Vulvar cancer|squamous cell carcinoma of the vulva]],
[[thalidomide]],
[[thalidomide]],
[[transformed lymphoma]],
[[Richter's transformation|transformed lymphoma]],
[[urothelial cancer ]]
[[Transitional cell carcinoma|urothelial cancer]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| '''Overdose/Toxicity'''
|bgcolor="Beige"|  
| bgcolor="Beige" |  
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| '''Renal/Electrolyte'''
|bgcolor="Beige"|  
| bgcolor="Beige" |  
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"|  
| bgcolor="Beige" |  
|-
No underlying causes|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|}
|}
Line 177: Line 201:
*[[Burkitt lymphoma]]
*[[Burkitt lymphoma]]
*[[Chronic myeloid leukemia]]
*[[Chronic myeloid leukemia]]
*[[Cytarabine]]
*[[Chemotherapy|Cytotoxic chemotherapy]]
*[[Chemotherapy|Cytotoxic chemotherapy]]
*[[Diffuse large B-cell lymphoma]]
*[[Diffuse large B-cell lymphoma]]
*[[Doxorubicin Hydrochloride]]
*[[Etoposide]]
*[[Etoposide]]
*[[Fludarabine]]
*[[Fludarabine]]
Line 190: Line 216:
*[[Hydroxyurea]]
*[[Hydroxyurea]]
*[[Imatinib]]
*[[Imatinib]]
*[[Isolated plasmacytomas]]
*[[Plasmacytoma|Isolated plasmacytomas]]
*[[Lenalidomide ]]
*[[Lenalidomide ]]
*[[Mantle cell lymphoma]]
*[[Mantle cell lymphoma]]
*[[Medulloblastoma]]
*[[Medulloblastoma]]
*[[Melanoma]]
*[[Melanoma]]
*[[Metastatic colorectal cancer ]]
*[[Colorectal cancer|Metastatic colorectal cancer ]]
*[[Multiple myeloma]]
*[[Multiple myeloma]]
*[[Neuroblastoma]]
*[[Neuroblastoma]]
Line 202: Line 228:
*[[Ovarian cancer ]]
*[[Ovarian cancer ]]
*[[Paclitaxel]]
*[[Paclitaxel]]
*[[Pralatrexate]]
*[[Radiation therapy ]]
*[[Radiation therapy ]]
*[[Rhabdomyosarcoma]]
*[[Rhabdomyosarcoma]]
Line 209: Line 236:
*[[Vulvar cancer|Squamous cell carcinoma of the vulva]]
*[[Vulvar cancer|Squamous cell carcinoma of the vulva]]
*[[Thalidomide]]
*[[Thalidomide]]
*[[Transformed lymphoma]]
*[[Richter's transformation|Transformed lymphoma]]
*[[Urothelial cancer ]]
*[[Transitional cell carcinoma|Urothelial cancer ]]
*[[Zoledronic acid]]
*[[Zoledronic acid]]
{{col-end}}
{{col-end}}
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]

Latest revision as of 13:42, 7 September 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Nazia Fuad M.D.

Overview

Development of tumor lysis syndrome is the result of initiation of chemotherapy or radiotherapy in cancer patients. The most common causes of tumor lysis syndrome are Burkitt's lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia and chemotherapy including methotrexate. Sometimes it can occur spontaneously without administration of treatment primarily in patients with non-Hodgkin lymphoma (NHL) or acute leukemia.

Causes

Common Causes

The most common causes of tumor lysis syndrome are:[1][2]

Less common causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect

Bortezomib, Carfilzomib, Cytarabine, cytotoxic chemotherapy, Doxorubicin Hydrochloride etoposide, fludarabine, glucocorticoids, hydroxyurea, Ibrutinib, imatinib, lenalidomide , Nelarabine, Nilotinib, Ofatumumab, paclitaxel, Pralatrexate, rituximab, thalidomide, Vincristine sulfate liposome zoledronic acid

Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic

Acute lymphoblastic leukemia , acute myeloid leukemia, adult T-cell leukemia/lymphoma , anaplastic large cell lymphoma, breast cancer , Burkitt's lymphoma, chronic myeloid leukemia, diffuse large B-cell lymphoma, gastrointestinal stromal tumors, germ cell tumors , hepatoblastoma, hepatocellular carcinoma, hodgkin's disease, isolated plasmacytomas, mantle cell lymphoma, medulloblastoma, melanoma, metastatic colorectal cancer , multiple myeloma, neuroblastoma, Non-Hodgkin lymphoma, ovarian cancer , rhabdomyosarcoma, sarcoma, small cell lung cancer, squamous cell carcinoma of the vulva, thalidomide, transformed lymphoma, urothelial cancer

Ophthalmologic No underlying causes
Overdose/Toxicity
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte
Rheumatology/Immunology/Allergy

No underlying causes|-

Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes by Alphabetical Order

References

  1. ↑ "www.asn-online.org" (PDF).
  2. ↑ Howard SC, Jones DP, Pui CH (May 2011). "The tumor lysis syndrome". N. Engl. J. Med. 364 (19): 1844–54. doi:10.1056/NEJMra0904569. PMC 3437249. PMID 21561350.

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