Tumor Lysis Syndrome

Question 1

What lab values best characterize tumor lysis syndrome

Answer 1

• hyperphosphatemia
• Hyperuricemia
• hyperkalemia
• hypocalcemia
• Elevated Creatinine
• Decreased GFR

Question 2

what cancers are most often associated with tumor lysis syndrome

Answer 2

• non-Hodgkin lymphoma
• acute lymphoblastic leukemia
• High-grade lymphomas
• Acute leukemias

Question 3

What agent(s) are recommended for the treatment of diffuse large b-cell lymphoma

Answer 3

• R-CHOP (Rituximab)

- CHOP (gold standard)

Question 4

Flow Cytometry Markers of:

- diffuse large B-cell lymphoma

Answer 4

CD19+, CD20+ , CD22+, CD79a+, CD10+/-

IRF4/MUM1+ important one to know (i think)

Question 5

Flow Cytometry Markers of:

- Burkitt lymphoma

Answer 5

BCL-2- (look at Kylie’s chart…there are a bunch)

Question 6

Flow Cytometry Markers of:

- Follicular lymphoma

Answer 6

IRF4/MUM1 - (Kylie’s chart has a ton more…not sure what ones are important)

Question 7

What are the two classifications for tumor lysis syndrome as defined by Cairo and Bishop

Answer 7

• Laboratory Tumor Lysis Syndrome

- Clinical Tumor Lysis Syndrome

Question 8

Be able to diagnose patients classification of tumor lysis syndrome

Answer 8

Chart on page 2 slide 5 of Kylie’s lecture

• Laboratory TLS: > 2 metabolic abnormalities occurring simultaneously within 3 days prior or 7 days post treatment OR a 25% change in values (uric acid > 476 / Potassium > 6 / Phos > 1.45 and Cal 1.5 / cardiac arrhythmia / seizure / sudden death)