Tumor Lysis Syndrome: An Endless Challenge in Onco-Nephrology

Tumor lysis syndrome (TLS) is a common cause of acute kidney injury in patients with malignancies, and it is a frequent condition for which the nephrologist is consulted in the case of the hospitalized oncological patient. Recognizing the patients at risk of developing TLS is essential, and so is th...

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Published in:Biomedicines 2022-04, Vol.10 (5), p.1012
Main Authors: Lupușoru, Gabriela, Ailincăi, Ioana, Frățilă, Georgiana, Ungureanu, Oana, Andronesi, Andreea, Lupușoru, Mircea, Banu, Mihaela, Văcăroiu, Ileana, Dina, Constantin, Sinescu, Ioanel
Format: Article
Language:English
Subjects:
Calcium phosphates
cancer
Cancer therapies
Cardiac arrhythmia
Chemotherapy
Dexamethasone
Epidemiology
Hematopoietic stem cells
Hyperkalemia
Hypocalcemia
Kidneys
Kinases
Laboratories
Leukemia
Lymphoma
Lysis
Metastasis
Monoclonal antibodies
Morbidity
Mortality
Multiple myeloma
Nephrology
Patients
Potassium
Radiation therapy
Review
Stem cell transplantation
toxicity
Tumor cells
tumor lysis syndrome
Tumor necrosis factor-TNF
Tumors
Uric acid
Urine
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Summary:Tumor lysis syndrome (TLS) is a common cause of acute kidney injury in patients with malignancies, and it is a frequent condition for which the nephrologist is consulted in the case of the hospitalized oncological patient. Recognizing the patients at risk of developing TLS is essential, and so is the prophylactic treatment. The initiation of treatment for TLS is a medical emergency that must be addressed in a multidisciplinary team (oncologist, nephrologist, critical care physician) in order to reduce the risk of death and that of chronic renal impairment. TLS can occur spontaneously in the case of high tumor burden or may be caused by the initiation of highly efficient anti-tumor therapies, such as chemotherapy, radiation therapy, dexamethasone, monoclonal antibodies, CAR-T therapy, or hematopoietic stem cell transplantation. It is caused by lysis of tumor cells and the release of cellular components in the circulation, resulting in electrolytes and metabolic disturbances that can lead to organ dysfunction and even death. The aim of this paper is to review the scientific data on the updated definition of TLS, epidemiology, pathogenesis, and recognition of patients at risk of developing TLS, as well as to point out the recent advances in TLS treatment.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines10051012