Tumour lysis syndromes (TLS) refers to a group of potentially life-threatening metabolic complications that occur as a result of rapid cell death in cancer treatment. It is seen most commonly in certain types of aggressive cancers, such as leukemia and lymphoma, where large numbers of malignant cells are destroyed during treatment, releasing their content into the bloodstream. This sudden release overwhelms the body's ability to eliminate and process these substances, leading to imbalances in electrolytes and metabolic byproducts.
TLS is characterized by several hallmark features, including hyperuricemia (elevated levels of uric acid), hyperkalemia (high levels of potassium), hyperphosphatemia (excess phosphate), and hypocalcemia (low levels of calcium). These imbalances can lead to various complications, such as acute kidney injury, cardiac arrhythmias, seizures, and even death if left untreated.
The onset of TLS typically occurs within 24 to 72 hours after initiating chemotherapy or radiation therapy, but it can also happen spontaneously in cases of rapidly growing tumors. Prompt identification and management of TLS are crucial to prevent serious complications. Treatment involves aggressive hydration, diuretics to increase urine output, and medications to lower uric acid levels. In severe cases, dialysis may be necessary to remove excessive electrolytes and metabolites from the bloodstream.
Overall, tumour lysis syndromes represent a medical emergency that requires close monitoring and intervention to mitigate its potentially life-threatening consequences. The aim of treatment is to normalize electrolyte imbalances, preserve kidney function, and prevent complications associated with TLS, thereby improving patient outcomes.
