Potential complications of tumor lysis syndrome include uremia and oliguric renal failure due to tubule precipitation of uric acid, calcium phosphate, or hypoxanthine. Severe electrolyte disturbances, such as hyperkalemia and hypocalcemia, predispose patients to cardiac arrhythmia and seizures.
What happens with tumor lysis syndrome?
Tumor lysis syndrome (TLS) is a condition that occurs when a large number of cancer cells die within a short period, releasing their contents in to the blood.
Is tumor lysis syndrome life threatening?
TLS is a group of problems with blood levels, including high levels of uric acid (hyperuricemia), potassium (hyperkalemia) and phosphate (hyperphosphatemia), and low levels of calcium (hypocalcemia). TLS is a potentially life-threatening problem and needs to be treated right away.
Which risk factor is associated with the development of tumor lysis syndrome?
The factors that increase risk of tumor lysis syndrome include elevated LDH, extensive bone marrow involvement, pre-existing renal disease and reduced urinary output, advance age, and the use of drugs that increase serum uric acid such as alcohol, thiazide diuretics, levodopa.
Which metabolic disorders can occur because of tumor lysis syndrome?
The metabolic derangement associated with tumor lysis syndrome are hyperkalemia, hypocalcemia, hyperphosphatemia, and hyperuricemia. Blood urea nitrogen (BUN), creatinine, and lactate dehydrogenase are also elevated in tumor lysis syndrome.
Which of the following symptoms might a patient experience with TLS?
Clinical symptoms include hyperkalemia, hyperphosphatemia, hypocalcemia, nausea, vomiting, diarrhea, anorexia, lethargy, hematuria, muscle cramps, syncopy, heart failure, and cardiac dysthymias.
Which organ is most commonly affected by Leukostasis a complication of leukemia?
The condition is characterized by abnormal aggregation and clumping of white blood cells in the blood vessels resulting in impaired blood flow and delivery of oxygen to the body’s cells. The brain and lungs are the two most commonly affected organs. Leukostasis most commonly occurs with acute myeloid leukemia.
Which drugs cause TLS?
Agents reported to cause tumor lysis syndrome include the following:
- Zoledronic acid.
How do you know when a tumor is dying?
Signs of approaching death
- Worsening weakness and exhaustion.
- A need to sleep much of the time, often spending most of the day in bed or resting.
- Weight loss and muscle thinning or loss.
- Minimal or no appetite and difficulty eating or swallowing fluids.
- Decreased ability to talk and concentrate.
What are the most common cancers that pose a risk of TLS upon treatment?
Although TLS can occur in patients with any type of cancer, it is most common with hematologic cancers, especially high-grade B-cell lymphomas such as Burkitt lymphoma.
Why is LDH elevated in tumor lysis syndrome?
An increase in lactate dehydrogenase (LDH) is typically seen in patients with TLS, probably because of anaerobic glucose metabolism. However, the elevation of LDH is not included in the laboratory definition of LDH and it is important to note that LDH is a very sensitive but quite nonspecific marker for TLS.
What is the treatment for tumor lysis syndrome?
In general, treatment of TLS consists of intensive hydration, stimulation of diuresis, and, more specifically, in the use of allopurinol and rasburicase.
What labs do you monitor for tumor lysis?
High-risk patients should have laboratory monitoring (BUN, creatinine, phosphate, uric acid, and calcium levels) prior to therapy and for 48-72 hours after treatment induction. Follow measurements at least three times per day, or more often if evidence of tumor lysis syndrome develops.