Tumor lysis syndrom
Does tumor lysis syndrome (TLS) mean anything to you? If not, you should know that it is a serious, often life-threatening complication of cancer treatment. In this situation, every moment and mistake can mean the difference between life and death. Tumor lysis syndrome occurs when tumor cells suddenly break down, leading to the release of large amounts of intracellular substances into the bloodstream. In this algorithm, you will learn how to recognize signs of tumor lysis syndrome in a patient's laboratory values and symptoms. In addition, completion of our algorithm will equip you with the knowledge to prevent the development of TLS and how to manage its acute complications. Do you want to be prepared for this serious complication and help your patient? Then run our algorithm and gain valuable knowledge that can help you save your patient's life!
Review
Acute lymphoblastic leukaemia is a rare disease with a variety of clinical manifestations. Establishing a correct diagnosis can sometimes be difficult, as the clinical and laboratory manifestations may not be clear at first. A child with suspected haemoblastosis should be referred to a specialized centre as soon as possible, as the diagnosis of this disease is complex. However, the treatment is also complex and some complications are specific and require the care of an experienced team to recognise and adequately manage them. This illustrative story guides the reader through the first few days of treatment for acute lymphoblastic leukemia - properly indicated supportive care helped manage a serious complication and allowed the necessary treatment to continue, which today gives children with this disease a high chance of a full cure.
MUDr. Ester Zápotocká - Department of Paediatric Haematology and Oncology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital - Head of the Department of Haematology
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Learning targets
2. The student recognises other risk conditions associated with tumour lysis syndrome and has knowledge of their management
3. The student is aware of the risk factors contributing to tumor lysis syndrome and knows how to prevent these risk factors
Key points
2. It is important to identify and correct laboratory abnormalities (hyperkalemia, hyperphosphatemia, hyperuricemia) and associated symptoms early
3. It is essential to emphasize adequate IV hydration, diuresis support, and prevention of AKI
4. When the indication criteria are met (renal dysfunction, hypervolaemia, refractory electrolyte imbalance), early consideration of RRT is appropriate
