Tumor Lysis Syndrome An acute, life-threatening condition that appears within 7 days of starting cytotoxic therapies in high-burden, rapidly growing & chemosensitive malignancy like Burkitt's lymphoma & ALL but can also spontaneously (before any treatments) occur in high grade lymphoma & Acute leukemia (both ALL and AML) and solid malignancies Treatments: • IV fluids (up to 5-6L/day) • For hyperkalemia, treat with Ca only if EKG changes, otherwise treat with "hyperkalemia cocktail" • For hyperuricemia: Renally—dosed Allopurinol. If uric acid > 10 mg/dl, treat with Rasburicase (6mg) Key Points: • These patients decompensate much quicker than you would think! • Aggressive hydration & make sure they have adequate UOP By Walid Malki, MD, MS @wandering_er #Tumor #Lysis #Syndrome #TLS #oncology #management #UricAcid
