Side Effect: Tumor Lysis Syndrome

Spontaneous tumor lysis syndrome:

• Certain types of cancer, such as Burkitt's lymphoma or acute leukemias, are made up of rapidly dividing cells.
• In some cases, these cells divide so rapidly that some of them spontaneously break apart and release substances from inside of their cells into the bloodstream. Lysis means "to break apart."

Chemotherapy-induced tumor lysis syndrome:

• When chemotherapy kills cancer cells quickly, the cells may break apart and release substances from inside of their cells into the bloodstream. Lysis means "to break apart."

SIgns of tumor lysis:

• Clinical sIgns of tumor lysis are rare. And as a result, you cannot often see signs of tumor lysis when it occurs.
• Laboratory signs of tumor lysis can be seen on routine blood draws.
  • Typically, clinicians look at a labs found on a CMP to see if the serum creatinine is elevated (a sign of reduced kidney function), and check to see if electrolyte abnormalities are present.
  • Uric acid levels in the blood are checked.
  • Lactate dehydrogenase (LDH) can serve as a serum marker for cellular breakdown.

Symptoms of tumor lysis:

• Symptoms of tumor lysis may include;
  • Heart arrhythmias or palpatations
  • Reduced urine output and the inability to pee despite drinking adequate amounts of liquid
  • Weakness
  • Confusion

• Patients with rapidly dividing cancers such as Burkitt's lymphoma or an acute leukemia are more likely to get tumor lysis syndrome than patients with other cancers.
• Tumor lysis syndrome is very rarely seen in patients with solid tumors such as breast, colon, lung, and prostate cancer.
• Other risk factors include how many cells are present in the body.
  • The more cells that are present, the higher the risk of tumor lysis syndrome.

• Allopurinol is usually given to prevent patients from developing tumor lysis syndome.
• On occasion, doctors prescribe a medication known as rasburicase (Elitek®) to patients who present to the hospital with laboratory evidence that they may be at higher risk for kidney problems when chemotherapy is given.
  • Rasburicase helps prevent the build up of uric acid, which can otherwise accumate and form crystals in the kidney and cause damage.

Intravenous Hydration:

• All patients with suspected tumor lysis syndrome receive aggressive intravenous hydration, usually with normal saline solution, to flush out the remnants of cancer cells through the kidneys

Rasburicase (Elitek):

• One or two doses of rasburicase may be given to help your body eliminate uric acid if doctors think that it is too high and causing your kidenys not work properly