Tumor Lysis Syndrome

Tumor lysis syndrome (TLS) is a life-threatening condition that can occur after treatment of a fast-growing cancer, especially certain blood cancers such as leukemia and lymphoma. TLS is usually linked with chemotherapy, but other types of cancer treatment may also lead to this syndrome.

As tumor cells die, they break apart and release their contents, including potassium, phosphate and tumor DNA, into the blood. This causes a change in electrolytes and certain chemicals in the blood, which may cause damage to the nervous system, kidneys, heart, liver and other organs or increase the level of potassium in the blood.

If you have one of the following diagnoses most commonly linked with TLS, ask your health care provider whether the therapies in your treatment plan have TLS as a potential side effect:

  • Acute lymphocytic leukemia
  • Acute myeloid leukemia
  • Burkitt lymphoma
  • Chronic lymphocytic leukemia
  • Large-cell lymphoma (type of non-Hodgkin lymphoma)
  • Small cell lung cancer

Some of the factors that can increase your risk of TLS during cancer treatment are identified from test results, making it important to make and keep your follow-up appointments for lab work and imaging scans:

  • High white blood cell level
  • High blood uric acid level
  • Kidney problems
  • Dehydration
  • Late-stage cancer
  • Large tumor size

If it is determined that you have a high risk of TLS, you may stay in the hospital during treatment so your medical team can monitor you closely with lab tests and blood work and deliver intravenous fluids and medications to help prevent TLS.

Whether you are deemed high or low risk, you are encouraged to keep information about your diagnosis and your treatment, including the name of the drug, your health care provider and your cancer center, with you at all times. This is critical in the event you experience TLS and you have to contact a health care professional who is unfamiliar with your treatment.

When does TLS usually occur?

The symptoms of TLS typically begin 12 to 72 hours following treatment. On rare occasions, it may occur before starting any cancer treatment or after a biopsy of a tumor.

When does TLS usually occur?

Because of the life-threatening potential of TLS, it is critical to contact your health care provider right away if you experience any of the following signs or symptoms:

  • Vomiting
  • Diarrhea
  • Muscle cramps or twitches
  • Dehydration
  • Peripheral neuropathy (numbness or ting-ling in your hands and feet; see Peripheral Neuropathy.
  • Decreased urination

These symptoms should be considered an emergency because TLS can potentially cause damage to the kidneys, heart, liver or other organs. The result can be loss of muscle control, seizures, kidney, liver or heart failure, or even death.