What is tumor lysis syndrome and how is it treated in patients with lymphoblastic lymphoma?

Updated: Sep 10, 2019
  • Author: Joseph M Tuscano, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Tumor lysis syndrome

Tumor lysis syndrome is a phenomenon observed most commonly in lymphomas with bulky masses. Tumor lysis occurs when cytotoxic agents kill high numbers of cells simultaneously, releasing large amounts of intracellular enzymes and electrolytes. The sudden osmotic load overwhelms the patient’s kidneys; renal failure typically occurs, with a rising creatinine level, hyperkalemia, and hyperuricemia, and may progress to oliguria and hypotension.

Treatment for tumor lysis syndrome is immediate intensive care with cardiac monitoring. Dialysis may be necessary. Continue chemotherapy, because the lysing of tumor cells resolves as the tumor burden decreases. If tumor lysis is anticipated, patients should be hydrated aggressively and observed in the intensive care unit (ICU) during the first chemotherapy treatment.


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