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Tumor lysis syndrome (TLS) can be a complication of having chemotherapy.
It can be a very serious and sometimes
life-threatening complication most commonly occurring after chemotherapy treatment in patients with leukemia or
high grade lymphoma.
"What is tumor lysis syndrome? There's
no good definition, but we can define it as metabolic derangement
produced by rapid tumor breakdown as a consequence of therapy. It's
characterized by hyperuricemia due to deoxyribonucleic acid (DNA)
breakdown, hyperkalemia because of cytosol breakdown,
hyperphosphatemia because of protein breakdown, and hypocalcemia
secondary to the hyperphosphatemia. As phoshate level goes up, serum
calcium goes down. These derangements can result in acute renal
failure secondary to urate nephropathy but also due to xanthine
nephropathy. Also, calcium phosphate can contribute to renal failure.
Cardiac dysrhythmias can occur secondary to
hyperkalemia and hypocalcemia, molecular symptoms such as cramps can
occur secondary to hypocalcemia, and there can be sudden death from
hyperkalemia or hypocalcemia.
When we treat patients with non-Hodgkin's
lymphoma, we frequently find tumor lysis syndrome; many times it's not
clinically significant. In other words, when there is tumor cell kill,
you can get some hyperuricemia and some hyperphosphatemia but, if it's
not severe enough, it will not result in the full-blown picture which
is known as clinically significant tumor lysis syndrome."
- Medscape
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