Tumor lysis syndrome(TLS)is a serious complication of anti-
cancer chemotherapy due to the spontaneous or therapyrelated rapid lysis of malignant cells. TLS is characterized by
hyperuricemia,
hyperkalemia,
hyperphosphatemia, and
hypocalcemia, which result in
acute renal failure and
metabolic acidosis. Factors predisposing to the development of TLS include a higher growth rate of cancerous cells, a higher sensitivity to
chemotherapy, impaired renal function before
chemotherapy, elevated
lactate dehydrogenase and
uric acid serum levels, and a large
tumor burden such as huge mass formation and extensive bone marrow involvement. Patients with TLS should be treated carefully with proper fluid management, urinary alkalization, correction of
acidosis and
electrolyte unbalance, inhibition of the formation of
uric acid or destruction of the already circulating
uric acid molecules, and a reduction of
chemotherapy intensity. Furthermore, the recombinant
urate oxidase(
rasburicase)significantly reduces the morbidity and mortality of TLS. Patients with malignant
tumors must be treated with the knowledge that the proper management prior to
chemotherapy, an early diagnosis, and an early aggressive treatment can prevent the occurrence of TLS.