Tumour lysis syndrome
Cairo-Bishop laboratory and clinical TLS, who is high risk (Burkitt, ALL, bulky lymphoma, venetoclax in CLL), prophylaxis with fluids plus allopurinol or rasburicase, G6PD checks, treating hyperkalaemia and hypocalcaemia safely, and when to dialyse.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Tumour lysis syndrome (TLS) is rapid tumour cell death releasing potassium, phosphate and nucleic acids (metabolised to uric acid) faster than the kidneys can clear them.
- It usually starts 12 to 72 hours after treatment begins, but bulky, fast-growing tumours can lyse spontaneously before treatment.
- The danger is hyperkalaemic arrhythmia and AKI from urate and calcium phosphate crystals.
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Sources
- British Society for Haematology updated guidelines for the diagnosis and management of tumour lysis syndrome in adults and children with haematological malignancies: a focus on patient safetyChan YLT et al., Br J Haematol 2025;207:1248-58, 2025
- Prevention of tumour lysis syndrome (ID 108)AU/NZeviQ, Cancer Institute NSW, Version 6, August 2025; G6PD testing added October 2025
- Therapeutic Guidelines: Oncology and Palliative Care (tumour lysis syndrome)AU/NZTherapeutic Guidelines Ltd
- Tumour lysis syndrome: new therapeutic strategies and classificationCairo MS, Bishop M. Br J Haematol 2004;127:3-11, 2004
- Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensusCairo MS et al., Br J Haematol 2010;149:578-86, 2010
- Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based reviewCoiffier B et al., J Clin Oncol 2008;26:2767-78, 2008
- The tumor lysis syndromeHoward SC, Jones DP, Pui CH. N Engl J Med 2011;364:1844-54, 2011
- Last updated
- 14 November 2026
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