The Pathophysiology of Tumor Lysis Syndrome in Oncology Patients

Patients with oncological conditions are at an increased risk of developing a wide variety of complications from chemotherapy that they would not otherwise be exposed too. One such life threatening complication is tumor lysis syndrome, which is an oncology emergency that frequently lands patients in the intensive care unit. Tumor lysis syndrome (TLS) occurs most frequently after the initiation of chemotherapy or other chemotoxic drugs during the patients’ treatment course [8]. It causes faster than normal tumor cell breakdown and release of intracellular contents into the general circulation. [8]. This leads to a very predictable development of electrolyte imbalances to take place within the body, which if not treated can lead to end-organ damage as well as fatal cardiac dysrhythmias [8]. While TLS is fairly uncommon, there are specific factors that place some individuals at a higher risk of developing TLS then others. These include large tumor size, tumors with rapid cell division, and hematological cancers such as leukemia [3]. In addition, TLS can progress extremely quickly and has a high rate of morbidity and mortality [8]. It is important that nurses and physicians are educated and on the look out for TLS in high-risk individuals and initiate prophylactic treatment if indicated. Also, prompt recognition of TLS and initiation of treatment modalities is key to preventing end-organ damage and possibly death. In oncology specific intensive care units, such as the medical intensive care unit at The James Cancer Hospital in Columbus, Ohio, TLS is one of the most common reasons for patients to receive continuous renal replacement therapy (CRRT) after sepsis. The purpose of this poster is to provide information to nurses on general oncology floors so that they are able to recognize the signs and symptoms of TLS early, in the hopes that early identification and treatment will improve patient outcomes and decrease the number of patients with acute kidney injuries necessitating the need for CRRT