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Understanding tumor lysis syndrome

  • Lara ZafraniEmail author
  • Emmanuel Canet
  • Michael Darmon
Understanding the Disease
Tumor lysis syndrome (TLS) is a life-threatening condition in patients with extensive and chemosensitive malignancies. It usually occurs as a consequence of anticancer treatments, although it can also arise spontaneously (in up to a third of TLS cases) [ 1, 2]. TLS results from the rapid destruction of malignant cells, whose intracellular content (ions, proteins, and metabolites) is consequently released into the extracellular space. Potassium, calcium, phosphates, and deoxyribonucleic acid (DNA), which are present in high concentrations in malignant cells, are released into the extracellular space, leading to hyperkalemia, hyperphosphatemia, and subsequent hypocalcemia. DNA catabolism leads to the release of adenosine and guanosine, which are converted into xanthine and then uric acid. TLS occurs when renal clearance is insufficient to handle this metabolite release. The above-described metabolic disturbances may contribute to the development of acute kidney injury (AKI), thereby...

Notes

Compliance with ethical standards

Conflicts of interest

L Zafrani has received a research grant from Jazz Pharma. Dr. Darmon reports grants from MSD, personal fees from Gilead-Kite, personal fees from Astelas, outside the submitted work; Dr. CANET reports personal fees from GILEAD, outside the submitted work.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Medical Intensive Care Unit, Hopital Saint Louis, Assistance des Hôpitaux de ParisParis UniversityParisFrance
  2. 2.INSERM, UMR 976, Human Immunology Pathophysiology and ImmunotherapyHôpital Saint LouisParisFrance
  3. 3.Intensive Care UnitNantes University HospitalNantesFrance

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