Tumor Lysis Syndrome in Solid Tumors: An up to Date Review of the Literature

Abstract

Tumor lysis syndrome (TLS) is a potentially deadly complication of tumors or their treatment. This syndrome consists of a constellation of laboratory findings such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, known as laboratory TLS. When clinical complications such as seizures, acute renal failure, and cardiac dysrhythmias occur in patients with laboratory TLS, the syndrome is called clinical TLS. TLS is especially common in patients with hematological malignancies with rapid cellular turnover rates such as acute lymphocytic leukemia and Burkitt lymphoma, but is very rare in patients with solid tumors. Nevertheless, there are multiple reports in the literature on the occurrence of TLS in patients with solid tumors. In this review article, we summarize the current data on the occurrence of TLS in patients with solid tumors. We propose an algorithm of risk stratification and prevention of TLS in patients with solid cancers.

Tumor lysis syndrome from a solitary nonseminomatous germ cell tumor

“…Spontaneous TLS can occur in solid organ malignancies (1). TLS in solid organ malignancies is provoked by chemotherapy or radiation therapy, which creates massive cell lysis and elaboration of intracellular potassium, phosphate, and uric acid as well as hypocalcemia, which can lead to renal failure and cardiac dysrhythmias (1).…”

Tumor lysis syndrome following radiation therapy in metastatic pancreatic cancer: A case report

“…Recent treatment developments and efficacy in solid tumors with chemotherapy and radiation may contribute to an increasing incidence of TLS with contemporary clinical approaches. [9] As mortality rates related to TLS have been reported to be higher with solid tumors as compared to hematologic malignancies, awareness and recognition is important in these settings. [9] Published by Sciedu Press…”

“…[9] As mortality rates related to TLS have been reported to be higher with solid tumors as compared to hematologic malignancies, awareness and recognition is important in these settings. [9] Published by Sciedu Press…”

A Case Report of Inflammatory Syndrome Presenting as Tumor Lysis Syndrome after Single Dose of Nivolumab

“…Hyperuricemia, hyperphosphatemia, and calcium phosphate deposition within the renal tubules can lead to acute kidney injury [1]. TLS is often seen after initiation of therapy in small cell lung cancer or highly aggressive lymphomas and leukemias, such as Burkitts lymphoma and T cell acute lymphoblastic leukemia [2]. It is due to the heavy tumor cell burden of these diseases that results in increase cell lysis during chemotherapy.…”

“…Nivolumab acts as an immunomodulator by blocking ligand activation of the programmed cell death 1 (PD-1) receptor on activated T cells. Currently, there are different known adverse effects of Nivolumab reported but TLS and cytokine storm have not been described yet [2].…”