Tumour Lysis Syndrome: Implications for Cancer Therapy

Abstract

The tumour lysis syndrome (TLS) is a group of metabolic abnormalities caused by rapid and unexpected releaseof cellular components into the circulation as a result of massive destruction of rapidly proliferating malignantcells. It usually develops in patients with hematologic malignancies like acute lymphoid leukemia, non-Hodgkinand Burkitt’s lymphoma after initiation of chemotherapy or may, rarely, occur spontaneously. Though TLS isseldom observed in relation to solid tumours, there have been reports of connections with examples such aslung, liver, breast, gastric carcinomas. The clinical manifestations of TLS include hyperuricemia, hyperkalemia,hyperphosphatemia and hypocalcemia. These indications if untreated lead to life-threatening complications suchas acute renal failure, cardiac arrhythmias, seizures, and eventually death due to multiorgan failure. Thereforeearly detection of TLS is of vital importance. This can be accomplished by identification of high risk patients,implementation of suitable prophylactic measures andmonitoring of the electrolyte levels in patients undergoingchemotherapy.