A previously healthy 25 year old patient presents with the following bloodwork following diagnosis of Burkitt’s lymphoma:
|WBC||25.6 x 109/L|
What is the major complication with his blood work and how should this be managed?
Tumor Lysis Syndrome: Caused by “dumping” of intracellular metabolites into the circulation.
- Renal failure
Most frequent in tumors with:
- High growth fractions
- Exquisite chemosensitivity
Examples: Lymphomas (esp. high grade), Leukemia, rarely in solid tumors
General treatment of tumor lysis syndrome:
- Aggressive IV fluid hydration, monitor u/o
- Allopurinol (300-600 mg/day)
- Rasburicase in case of contraindication for allopurinol
- Aggressive management of hyperkalemia
- Early dialysis and inotropic support as needed