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2020, Number 2

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Acta Med 2020; 18 (2)

Tumor lysis syndrome

Ochoa SH, Espinosa SA, Hurtado MR

Language: Spanish
References: 20
Page: 177-184
PDF size: 186.98 Kb.


ABSTRACT

Tumor lysis syndrome (TLS) is a life-threatening complication secondary to the release to the blood of cellular components following the massive lysis of malignant cells. It can trigger acute kidney injury, arrhythmias and seizures. It usually occurs in the first cycle of chemotherapy, or throughout the treatment. It is associated in most cases with cytotoxic chemotherapy, but also by the use of therapeutic anti-CD20 monoclonal antibodies. There are two types: TLS manifested as a clinical syndrome or with laboratory changes. The TLS laboratory is more common, and it is defined by the appearance in 24 hours of two or more abnormalities in electrolytes or uric acid. For its diagnosis, the Cairo-Bishop and Howard criteria are used. The measures to prevent it include monitoring of laboratories, hypouricemiantes and adequate hydration. This follow-up with laboratories should be followed during the high-risk period. Adequate hydration is the most important measure, because it promotes the excretion of uric acid and phosphate. Hypouricemic agents such as allopurinol or newer agents such as febuxostat can be effective. The TLS has been observed frequently, although not severely, with some of the new treatment agents of chronic lymphocytic leukemia.


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