Tumour Lysis Syndrome

Question 1

Risk stratification - high risk TLS conditions

Answer 1

High risk - TLS Q4H + Telemetry
1. Burkitt lymphoma
2. ALL
3. Hyperleukocytic leukaemias (>100)
4. High baseline LDH (more than double) and uric acid

Lower risk - lymphoma
(6 hour post treatment then once a day)

Question 2

Tumour lysis syndrime

Answer 2

1. Hyperkalaemia
2. Hypocalcaemia
3. Hyperphosphataemia
4. Hyperuricaemia
5. High LDH (doubled or overtly high)
6. Renal impairment

Question 3

Cairo Bishop criteria for TLS

Question 4

Methotrexate toxicity

Answer 4

Neurotoxicity
Renal toxicity (irony as MTX renally excreted)
Hepatotoxicity
Myelosuppression
Mucositis of skin and internal organs