Tumor Lysis Syndrome

Tumor Lysis Syndrome (TLS) refers to the metabolic consequences of the break-up of a tumor within the body, generally on account of cytotoxic (i.e. chemotherapeutic) intervention. In other words, when a cancer patient receives treatment, the cancer cells that are killed release their contents into the bloodstream and throw the metabolic state of the blood out of balance. This is characterized by three serious conditions:

Hyperkalemia: This is a build-up of potassium in the blood, or higher-than-normal levels of potassium in the blood.

Hyperphosphatemia: This is a build-up of phosphates in the blood.

Hyperuricemia: This is a build-up of uric acid in the blood

In all cases, it is the role of the kidneys to clear these substances from the blood, which is why kidney failure is a very real concern when coping with TLS.

Risk Factors for TLS

The highest degree of risk for TLS derives from those tumors that are known to grow the fastest, chiefly because they are known to be most susceptible to chemotherapy and similar anti-cancer interventions. These tumors include:

-- Lymphoblastic Lymphoma
-- Burkitt's lymphoma
-- T-cell acute lymphoblastic leukemia

Lower risk tumors include:
-- Low grade lymphomas
-- Small cell carcinomas
-- Breast carcinomas
-- Multiple myelomas

Other risk factors include:

-- Bulky disease
-- Hepatosplenomegaly (the swelling of the liver and the spleen beyond normal size)
-- High leukocyte count
-- Elevated LDH levels (pre-treatment)
-- Elevated levels of uric acid (pre-treatment)
-- Compromised kidney functions
-- Decreased urine output

Treatment strategies

There are several treatment strategies for Tumor Lysis Syndrome, and the subject is far too extensive for the scope of this entry. However, patients should be made aware by their physicians if they are at higher risk of developing TLS following anti-cancer treatment, and if so, what prophylactic measures can be taken to prevent the syndrome from developing in the first place.

Sources

Boyiadzis, Michael M. et al. Hematology-Oncology Therapy. 2007. New York: McGraw Hill, Medical Publishing Division.
PubMed Health: Hyperkalemia
MedlinePlus: Hepatomegaly

More Articles

More Articles

This article looks at the Non-Hodgkin's Lymphoma survival rate as well as the Non-Hodgkin's Lymphoma mortality rate ....

The term NK T cell lymphoma refers to one of two subtypes of lymphoma that affect the NK (Natural Killer)...

Canine lymphoma is a fairly common cancer in American dogs. The most commonly seen lymphoma in America is a type called Lymphosarcoma, although...

Prednisone is a glucocorticosteroid (a steroid) used in the treatment of many types of cancers. It functions as an anti-inflammatory medicine that...

Marginal zone lymphomas (MZL) are indolent lymphomas that affect the B-cells. The...

Large Cell Lymphoma (LCL) is typically an aggressive (fast growing) cancer of either the B cell or T cell type. They are one of the most common...

A B cell is a type of lymphocyte that produces antibodies to fight infections. These are the most prevalent lymphocytes in the bloodstream and are...

Aggressive Non-Hodgkin’s Lymphomas (NHLs) are fast growing cancers (as opposed to indolent cancers). They involve...

A lymphoma prognosis varies greatly depending on the type of lymphoma. There are more than 35 types of lymphoma, including 5 types of...

What causes lymphoma is not well known. DNA mutations may be what causes lymphoma to develop but what triggers these mutations is...

Often the one who makes the first diagnosis of Hodgkin's Lymphoma / Disease is the person affected. There are some...

Lymphedema is abnormal swelling due to the presence of excess lymphatic fluid within the tissues. This swelling occurs when the...

RICE is an acronym for an anti-cancer treatment that expresses a combination chemotherapeutic regimen. This regimen is written variously as "R+ICE...

Hodgkin's Disease—also referred to as Hodgkin's Lymphoma, these are the exact same diseases, just...

Lymphoma is a cancer affecting the white blood cells (lymphocytes) of the body's immune system. The cells begin to grow abnormally and much faster...