Open AccessAcute Tumor Lysis Syndrome: A Metabolic Emergency in Cancer Patients
Author(s) -
Giorgio Attinà,
Raffaele Tepedino,
Antonio Ruggiero
Publication year - 2021
Publication title -
biomedical and pharmacology journal/biomedical and pharmacology journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.191
H-Index - 18
eISSN - 2456-2610
pISSN - 0974-6242
DOI - 10.13005/bpj/2273
Subject(s) - tumor lysis syndrome , hyperuricemia , rasburicase , medicine , hyperkalemia , hyperphosphatemia , allopurinol , chemotherapy , lymphoma , intensive care medicine , oncology , uric acid , kidney disease
Tumor lysis syndrome (TLS) can be a life-threatening complication that occurs following the onset of chemotherapy treatment, most commonly in association with high-grade lymphoproliferative pathologies such as acute lymphoblastic leukemia and Burkitt lymphoma. The massive cell lysis caused by cytotoxic therapy leads to the rapid release in the blood of intracelullary products and the onset of severe metabolic and electrolytic complications (hyperkalemia, hyperphosphatemia, hypocalcemia and hyperuricemia) upto the acute renal failure. This article describes the incidence and pathophysiological basis of TLS, focusing on the new therapeutic strategies implemented over the last few years, especially with regard to the treatment of hyperuricemia. In particular, it highlights the characteristics of a recent drug, Rasburicase, as a safe and effective alternative, compared to traditional allopurinol therapy, for prophylaxis and treatment of children with hyperuricemia induced by chemotherapy.