Complications of tumor lysis syndrome during cancer treatment

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Complications of tumor lysis syndrome can occur acutely or after treatment for a long time. The toxicity of tumor lysis may be related to cancer drugs or from the tumor's response to treatment. Tumor lysis syndrome is most common in patients with non-hodgkin lymphoma or acute leukemia, however, the possibility of any rapidly progressing cancer cannot be excluded.

1. What is tumor lysis syndrome?

Tumor lysis syndrome is a serious complication that can occur in the early stages of cancer treatment due to spontaneous release of intracellular ions and metabolites from malignant cells before or after initiation of cancer. develop cytotoxic therapy. More specifically, when cancer cells die and break off, they release substances into the bloodstream including potassium, phosphorus, and nucleic acids. It is because of the high concentrations of these substances that can cause metabolic changes that damage the heart, kidneys, liver and other organs, and even lead to death.
Some patients with cancers such as Burkitt lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia, or other risk factors should be closely monitored during the early stages of treatment. Prophylactic treatments may be intravenous fluids and drugs such as rasburicase, allopurinol to control uric acid elevations, anthanum or aluminum hydroxide to control phosphorus elevations.

2. Manifestations of u . lysis syndrome

Symptoms in tumor lysis syndrome are the result of metabolic imbalance in the body. Possible symptoms in the patient include:
Nausea, vomiting Diarrhea Loss of appetite Convulsions Changes in heart rate Muscle cramps or spasms Fainting Fatigue, lethargy Fluid retention, swelling or edema

However, these symptoms can also be found as a side effect of chemotherapy in the patient or some other cause. Patients with the following risk factors are also susceptible to tumor lysis syndrome:
Acute leukemia Cancer rapidly progressing Cancer rapidly responding to chemotherapy Large tumors Advanced stage Cancer burden Major cancers In patients with preexisting high uric acid or phosphate levels or poor kidney function, low blood pressure is also a contributing factor to tumor lysis syndrome.

3. How is tumor lysis syndrome treated?

Prevention is the best way to treat tumor lysis syndrome. Preventive measures include:
Isotonic infusion with 0.9% NaCl or Ringerlactate 2-3 liters/day aimed at maintaining urine output range of 80-100ml/hour Using diuretic Furosemide 20mg IV Reduce blood uric acid by using Rasburicase, Allopurinol 300 mg orally 2-3 tablets/day. However, it is also necessary to base on the level of risk to decide to use uric acid-reducing drugs as high-risk patients should give priority to using Rasburicase for both adults and children. Inject calcium chloride 0.5g: 1-2 intravenous tubes, intravenous sodium carbonate infusion. The dose may be repeated in the presence of hyperkalemia and hypocalcaemia until serum potassium returns to normal and there are no ECG signs. When medical treatment fails, extra-renal dialysis can be performed. To limit complications of tumor lysis syndrome during cancer treatment, patients should actively undergo periodic health check-ups and follow the doctor's instructions. specialists in the treatment of diseases in order to bring good results.

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