Risk evaluation, prophylaxis, and treatment of tumor lysis syndrome: Consensus of an italian expert panel

Andrea Pession, Riccardo Masetti, Gianluca Gaidano, Patrizia Tosi, Giovanni Rosti, Massimo Aglietta, Giorgina Specchia, Fulvio Porta

Research output: Contribution to journalArticle

Abstract

Tumor lysis syndrome (TLS) is a life-threatening complication in patients with hematological disease and/or solid tumors that results from rapid, large-scale tumor necrosis occurring spontaneously, or more commonly, as a result of chemotherapy. TLS is characterized by metabolic and electrolyte imbalances that include hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Identification of risk groups as well as early detection of TLS is crucial for the establishment of appropriate strategies of prophylaxis and treatment. Methods: A review of the peerreviewed literature on TLS between 1990 and 2011 was conducted via a systematic search of the PubMed database using the keywords 'TLS' [AND] 'management,' 'risk evaluation,' 'prophylaxis,' and 'treatment.' An expert opinion-based approach was used to review the national and international recommendations and guidelines on the topic. Results: The PubMed search produced 90 results, all of which were evaluated. These studies, together with a recent international consensus panel provided recommendations for evaluating the risk of TLS and providing prophylaxis. Five algorithms are presented that consider all of the factors when assessing the risk for neoplastic disease in general, and specifically for leukemia and lymphoma. Conclusion: The present report provides clinicians with an easily consultable tool to guide the evidence-based management of this oncohematological emergency.

Original languageEnglish
Pages (from-to)684-697
Number of pages14
JournalAdvances in Therapy
Volume28
Issue number8
DOIs
Publication statusPublished - Aug 2011

Keywords

  • Allopurinol
  • Expert panel
  • Hyperuricemia
  • Rasburicase
  • Tumor lysis syndrome

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Medicine(all)

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