Tumor Lysis Syndrome: Symptoms, Causes, Treatment
متلازمة تحلل الورم
Tumor lysis syndrome is a dangerous disturbance caused by rapid cancer-cell breakdown releasing contents into blood. Kidney function and heart rhythm can be affected, requiring prevention, monitoring and urgent treatment.
What is Tumor Lysis Syndrome?
It often follows treatment of certain cancers but can occur beforehand. Laboratory changes may precede symptoms, so feeling well does not replace scheduled monitoring.
Related reading: Cytokine release syndrome as a different treatment complication.
Symptoms
Reduced urine, nausea, vomiting, fatigue, cramps or palpitations may develop. Fainting, seizures or breathlessness can occur; some cases are first detected through blood tests.
Causes
Potassium, phosphate and uric acid rise and calcium may fall as cells break down. Kidneys may not clear this load, particularly with pre-existing impairment or dehydration.
Risk factors
Rapidly growing tumors, large disease burden, certain leukemias and lymphomas, high uric acid, renal impairment and dehydration increase risk in relation to the treatment used.
Diagnosis
Risk assessment considers cancer, treatment and kidney function. Electrolytes, uric acid, creatinine, urine output and ECG are monitored as indicated and interpreted in clinical context.
Treatment
Care uses carefully balanced fluids, cardiac and electrolyte monitoring and risk-based uric-acid treatment; dialysis may be necessary. Rasburicase must not be used in G6PD deficiency, which is checked before prescribing.
Complications
Kidney injury, dangerous heart rhythms, seizures or cardiac arrest can result. Early recognition and correction reduce harm without guaranteeing complete prevention.
Prevention
Prevention may start before cancer treatment with repeat testing and fluids tailored to heart and kidney function. Do not force fluids or self-administer bicarbonate or electrolyte supplements.
When to see a doctor
Tell the oncology team immediately about low urine, severe vomiting or weakness after treatment. Palpitations with dizziness, fainting, seizures or breathlessness requires emergency help.