Tumor Lysis Syndrome: An Endless Challenge in Onco-Nephrology

Biomedicines - Tập 10 Số 5 - Trang 1012
Gabriela Elena Lupusoru1,2, Ioana Ailincăi1,2, Georgiana Frățilă1,2, Oana Ungureanu1,2, Andreea Andronesi1,2, Mircea Lupușoru3, Mihaela Banu4, Ileana Adela Văcăroiu1,5, Constantin Dina6, I. Sinescu7,1
1Department of Nephrology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
2Department of Nephrology, Fundeni Clinical Institute, 022328 Bucharest, Romania
3Department of Physiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
4Department of Anatomy, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
5Department of Nephrology, Sf Ioan Clinical Emergency Hospital, 042122 Bucharest, Romania
6Department of Anatomy, Ovidius University, 900527 Constanța, Romania
7Center for Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania

Tóm tắt

Tumor lysis syndrome (TLS) is a common cause of acute kidney injury in patients with malignancies, and it is a frequent condition for which the nephrologist is consulted in the case of the hospitalized oncological patient. Recognizing the patients at risk of developing TLS is essential, and so is the prophylactic treatment. The initiation of treatment for TLS is a medical emergency that must be addressed in a multidisciplinary team (oncologist, nephrologist, critical care physician) in order to reduce the risk of death and that of chronic renal impairment. TLS can occur spontaneously in the case of high tumor burden or may be caused by the initiation of highly efficient anti-tumor therapies, such as chemotherapy, radiation therapy, dexamethasone, monoclonal antibodies, CAR-T therapy, or hematopoietic stem cell transplantation. It is caused by lysis of tumor cells and the release of cellular components in the circulation, resulting in electrolytes and metabolic disturbances that can lead to organ dysfunction and even death. The aim of this paper is to review the scientific data on the updated definition of TLS, epidemiology, pathogenesis, and recognition of patients at risk of developing TLS, as well as to point out the recent advances in TLS treatment.

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