review | tumour lysis syndrome

Breaking down the tumour is usually a good thing – except when there’s a massive load of tumour cells and it all becomes a bit overwhelming. So what exactly happens – and how do you stop it?

Basically, when the cancer cells break down, they release a few nasties – potassium and phosphorus, as well as a few nucleic acids that end up as uric acid. This leads to a multitude of problems, including cardiac arrhythmias, seizures, and renal failure, which all doesn’t help when you’ve just started chemotherapy (although it can happen spontaneously too). 

Look at the bloods, for the following:

– high potassium
– high phosphate
– high uric acid
– high creatinine
– low calcium

The key approaches to management are to prevent the complications, and to choose therapy wisely if someone is at high risk. This article from the New England Journal of Medicine carefully describes the laboratory and clinical diagnosis of tumour lysis syndrome and provides some great algorithms on management.

Read it here

IMAGE euthman


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