Tumor lysis syndrome overview: Difference between revisions
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Development of tumor lysis syndrome is the result of initiation of [[chemotherapy]] or [[radiotherapy]] in cancer patients. | Development of tumor lysis syndrome is the result of initiation of [[chemotherapy]] or [[radiotherapy]] in cancer patients. | ||
==Causes== | ==Causes== | ||
Tumor lysis syndrome (TLS) is a group of metabolic abnormalities resulting from rapid lysis of malignant cells and massive release of cell breakdown products into the blood among patients with hematologic malignancies treated with chemotherapy. 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). Usually, the precipitating medication regimen includes combination [[chemotherapy]], but those patients with lymphoma and ALL can be affected with [[steroid]] treatment alone. | |||
==Tumor Lysis Syndrome Differential Diagnosis== | ==Tumor Lysis Syndrome Differential Diagnosis== | ||
Tumor lysis syndrome must be differentiated from other diseases that cause [[hyperuricemia]], [[hyperkalemia]], and [[hyperphosphatemia]], such as [[acute kidney injury]].<ref name="pmid24359983">{{cite journal| author=Wilson FP, Berns JS| title=Tumor lysis syndrome: new challenges and recent advances. | journal=Adv Chronic Kidney Dis | year= 2014 | volume= 21 | issue= 1 | pages= 18-26 | pmid=24359983 | doi=10.1053/j.ackd.2013.07.001 | pmc=PMC4017246 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24359983 }} </ref> | Tumor lysis syndrome must be differentiated from other diseases that cause [[hyperuricemia]], [[hyperkalemia]], and [[hyperphosphatemia]], such as [[acute kidney injury]].<ref name="pmid24359983">{{cite journal| author=Wilson FP, Berns JS| title=Tumor lysis syndrome: new challenges and recent advances. | journal=Adv Chronic Kidney Dis | year= 2014 | volume= 21 | issue= 1 | pages= 18-26 | pmid=24359983 | doi=10.1053/j.ackd.2013.07.001 | pmc=PMC4017246 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24359983 }} </ref> | ||
Revision as of 19:15, 23 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
In medicine (oncology and hematology), tumor lysis syndrome (TLS) is a group of metabolic complications that can occur after treatment of cancer, usually lymphomas and leukemias, and sometimes even without treatment. These complications are caused by the break-down products of dying cancer cells and include hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia, and acute renal failure.
Classification
Tumor lysis syndrome (TLS) may be classified according to the 1993 Hande-Garrow classification system into two groups: laboratory tumor lysis syndrome (LTLS) and clinical tumor lysis syndrome (CTLS).[1]
Pathophysiology
Development of tumor lysis syndrome is the result of initiation of chemotherapy or radiotherapy in cancer patients.
Causes
Tumor lysis syndrome (TLS) is a group of metabolic abnormalities resulting from rapid lysis of malignant cells and massive release of cell breakdown products into the blood among patients with hematologic malignancies treated with chemotherapy. 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). Usually, the precipitating medication regimen includes combination chemotherapy, but those patients with lymphoma and ALL can be affected with steroid treatment alone.
Tumor Lysis Syndrome Differential Diagnosis
Tumor lysis syndrome must be differentiated from other diseases that cause hyperuricemia, hyperkalemia, and hyperphosphatemia, such as acute kidney injury.[2]
Epidemiology and Demographics
The exact incidence of tumor lysis syndrome has not been established. There is no racial or sex prediction for tumor lysis syndrome.[3]
Risk Factors
The most potent risk factor in the development of tumor lysis syndrome after initiating chemotherapy is kidney disease. Other risk factors include dehydration, hematologic tumors, and solid tumors.
References
- ↑ Cairo MS, Bishop M (2004). "Tumour lysis syndrome: new therapeutic strategies and classification". Br J Haematol. 127 (1): 3–11. doi:10.1111/j.1365-2141.2004.05094.x. PMID 15384972.
- ↑ Wilson FP, Berns JS (2014). "Tumor lysis syndrome: new challenges and recent advances". Adv Chronic Kidney Dis. 21 (1): 18–26. doi:10.1053/j.ackd.2013.07.001. PMC 4017246. PMID 24359983.
- ↑ Locatelli F, Rossi F (2005). "Incidence and pathogenesis of tumor lysis syndrome". Contrib Nephrol. 147: 61–8. doi:10.1159/000082543. PMID 15604606.