Tumor lysis syndrome primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Overview

Effective measures for the primary prevention of tumor lysis syndrome include allopurinol, rasburicase, and intravenous hydration.

Prevention

Before initiating chemotherapy for cancer patients, especially lymphomas and leukemias, should receive the following:

• Allopurinol
• Rasburicase (uricase) is an alternative to allopurinol and is reserved for patients who are high-risk in developing TLS
• Adequate IV hydration to maintain a high urine output (> 2.5 L/day)
• Alkalinization of the urine with acetazolamide or sodium bicarbonate is controversial