Tumor lysis syndrome (TLS)

Tumor lysis syndrome (TLS) is a life-threatening oncologic emergency caused by the rapid breakdown of tumor cells, leading to the release of intracellular contents into the bloodstream. This results in metabolic abnormalities that can cause organ dysfunction.

Causes:

TLS commonly occurs after chemotherapy or radiation therapy in rapidly proliferating tumors, particularly:

• Hematologic malignancies (e.g., leukemia, lymphoma, high-grade Burkitt’s lymphoma)

• Solid tumors (less common but can occur in rapidly growing ones)

Pathophysiology:

The rapid destruction of tumor cells leads to:

• Hyperkalemia → Cardiac arrhythmias

• Hyperphosphatemia → Secondary hypocalcemia (calcium-phosphate precipitation) → Renal failure

• Hypocalcemia → Tetany, seizures, arrhythmias

• Hyperuricemia → Uric acid nephropathy → Acute kidney injury (AKI)