Tumour lysis syndrome
Definition Tumour lysis syndrome (TLS) results from metabolic disturbances arising from the breakdown of malignant cells following the initiation of treatment for malignancy. Rapid cellular breakdown leads to the release of intracellular components (namely potassium, phosphate, and nucleic acids) resulting in a series of electrolyte abnormalities: Hyperkalaemia Hyperphosphataemia Hypocalcaemia Hyperuricaemia (from metabolism of nucleic acids) Acute kidney injury (AKI), arrhythmias and sudden death may occur as a consequence. Aetiology TLS occurs following the initiation of cytotoxic therapy in patients wth high-risk malignancies. TLS may occur in any tumour type, however, the incidence is greatest with the haematological malignancies. Factors associated with increased risk of TLS include: