Tumor Lysis Syndrome (TLS)

  1. What is the pathophysiology of uric acid excretion?
    a variety of metabolic abnormalities resulting from abrupt release of intracellular components into the bloodstream after the rapid lysis of malignant cells
  2. What is the MOA of Allopurinol?
    blocks xanthine oxidase from turning hypoxanthine into xanthine and xanthine into uric acid
  3. What is the MOA of rasburicase?
    breaks uric acid down into Allantoin and hydrogen peroxide
  4. What are the common metabolic abnormalities associated with Tumor Lysis Syndrome (TLS)?
    • hyperuricemia
    • hyperkalemia
    • hyperphosphatemia
    • hypocalcemia
  5. What are the risk factors for TLS?
    • lymphomas
    • ALL
    • AML
    • solid tumors with high proliferative rates and rapid response to tx
    • bulky tumors
    • elevated LDH
    • elevated WBC
    • preexisting renal failure
    • oliguria
    • high baseline uric acid levels
  6. What is the tx for low risk of TLS (WBC < 50,000)?
    close monitoring
  7. What is the tx for intermediate risk of TLS (WBC 50,000-10,0000 in ALL or 10,000-50,000 in AML)?
    Allopurinol + hydration
  8. What is the tx for high risk of TLS (lymphoma)?
    Rasburicase + hydration
Card Set
Tumor Lysis Syndrome (TLS)
Tumor Lysis Syndrome (TLS)