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Emergencies >> Tumor lysis syndrome

Background:

Rapid turnover of tumor cells before therapy, or destruction of tumor cells during therapy can lead to tumor lysis syndrome, especially in acute leukemia, and highly aggressive NHL (e. g. Burkitt NHL)


Symptoms:

Nausea, vomiting, fatigue, muscle aches, dark urine, hyperkalemia, hyperphosphatemia, hypocalcemia and lactic acidosis.


Therapy:

Correction and treatment of hyperkalemia, hyperphosphatemia, hyperuricemia and acute renal failure

PREVENTION is paramount in the treatment of patients with risk factors for tumor lysis syndrome:

  • NaCl 0,9% 3 l/day hydration (in absence of contraindications)
  • 250 ml Na-bicarbonate 8,4% over 24 h daily
  • Allopurinol (or rasburicase)
  • Urine-pH
  • Only hospitals with intensive care unit
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