Tumour Lysis Syndrome Flashcards
What is Tumour Lysis Syndrome?
Metabolic + electrolyte complication of cancer tx.
Lots of tumour cells lysed simultaneously by tx, releasing their contents into the bloodstream.
Results in hyperuricaemia, hyperphosphataemia, hyperkalaemia, + hypocalcaemia
Describe the aetiology of tumour lysis syndrome
Sudden lysis of many tumour cells, which release their toxic contents into the blood stream
Occurs most commonly after tx of lymphomas + leukaemias
Leads to high urate + K+ in plasma + renal injury
List 3 tumour characteristics considered risk factors for tumour lysis syndrome
High cell turnover rate
Rapid growth rate
High tumour bulk
List 3 patient characteristics considered risk factors for tumour lysis syndrome
Baseline serum creatinine
Renal insufficiency
Dehydration
Give a chemotherapy characteristic considered risk factors for tumour lysis syndrome
chemo-sensitive tumours (e.g. lymphoma) tends to have a higher risk
Describe the epidemiology of Tumour Lysis Syndrome
Most commonly in patients with poorly differentiated lymphomas + leukaemias esp Burkitt’s + ALL
List 3 signs and symptoms of hyperkalaemia in Tumour Lysis Syndrome
Arrhythmias: syncope/ chest pain/ dyspnoea
Severe muscle weakness + paralysis
Parasthesia
What results from hyperphosphataemia in Tumour Lysis Syndrome?
AKI due to deposition of calcium phosphate crystals in the kidney parenchyma
List 7 signs and symptoms of hypocalcaemia in Tumour Lysis Syndrome
Tetany Parasthesia Trousseau + Chvostek sign Myopathy Parkinsonism Sudden mental incapacity Hyperuricaemia
List 4 signs and symptoms of biochemical imbalance in Tumour Lysis Syndrome
N+V+D
Anorexia
Muscle weakness + cramps
Lethargy
Describe the metabolite levels in Tumour Lysis Syndrome
K+ high Phosphate high Uric acid high LDH high Ca2+ LOW
What deteriorations should be monitored for in Tumour Lysis Syndrome?
Renal failure: Increased serum creatinine
Arrhythmia: ECG
Seizure: Hyperkalaemia
What bloods/ general results are seen in Tumour lysis syndrome?
Lactic acidosis
Cr high
Urea high
WBC high
What does hyperuricaemia in tumour lysis syndrome lead to?
Gout
How does hypocalcaemia arise in tumour lysis syndrome?
Calcium precipitates to form calcium phosphate, so serum calcium drops
