Description
This oncology presentation on Tumor Lysis Syndrome (TLS) provides a concise yet comprehensive overview of this oncologic emergency, detailing its pathophysiology, risk factors, clinical manifestations, and management. The material explains TLS as a metabolic crisis resulting from the rapid lysis of tumor cells, commonly seen in hematologic malignancies like acute lymphoblastic leukemia and Burkitt lymphoma, leading to hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and acute kidney injury. Key risk factors include high tumor burden, chemosensitivity, preexisting renal impairment, and dehydration. Clinical features range from oliguria and flank pain to cardiac arrhythmias and neuromuscular symptoms of hypocalcemia. Management emphasizes prevention through hydration, allopurinol, or rasburicase, alongside prompt recognition and supportive care, including hemodialysis for severe cases. This resource is essential for medical students, oncology trainees, and practitioners in Zambia, offering structured, exam-focused content for understanding and managing TLS within a tertiary medical education setting. Download these notes for thorough preparation on oncologic emergencies.
What's inside
TUMOR LYSIS SYNDROME PRESENTER: ELIZABETH T.J HIKAUMBA MODERATOR: DR MWANZA What is it? Is an oncologic emergency Constellation of metabolic disturbances that occur when large numbers of neoplastic cells are killed rapidly Leads to the release of ions and metabolic byproducts into the systemic circulation Typically associated with bulky, rapidly proliferating, treatment responsive tumors E.g ALL, non-Hodgkin lymphomas like Burkitt lymphoma Risk factors Hematologic malignancies High tumor cell proliferation rate Chemosensitivity of the malignancy Large tumor burden Pretretment hyperuricemia or hyperphosphatemia Preexisitng nephropathy Dehydration Pathophysiology Clinically characterized by; Hyperuricemia Hyperkalemia Hyperphosphatemia Hypocalcemia Acute kidney injury Clinical presentation Urinary symptoms; Dysuria Oliguria Flank pain hematuria Symptoms of hypocalcemia; Anorexia Vomiting Seizures Spasms Altered mental status Paresthesia and tetany (+ve Chvostek and Trousseau signs) Symptoms of hyperkalemia; Weakness Paralysis Cardiac arrhythmias Symptoms due to calcium deposition; Pruritus Arthritis Iritis Gangrenous changes of skin Other manifestations Cardiac dysrhythmias Lethargy Fluid overload Syncope Sudden death Diagnosis Principles of management Identification of high risk patients with initiation of preventive therapy Early recognition of metabolic and renal complications and prompt administration of supportive care (i.e hemodialysis) Preventive measures Foremost hydration (when possible, delay tumor therapy) Allopurinol (24hrs before chemo) or rasburicase Treatment of TLS QUESTIONS??
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