Please enable JavaScript.
Coggle requires JavaScript to display documents.
Acute Tumor Lysis Syndrome (Topic: Metabolism) - Coggle Diagram
Acute Tumor Lysis Syndrome (Topic: Metabolism)
Pathophysiology
Occurs as a result of malignant cell death from chemotherapy or other cytotoxic cell treatments.
Intracellular contents released in the blood include potassium, phosphorus, and nucleic acids.
Leads to hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia.
Hyperphosphatemia leads to hypocalcemia due to phosphate molecules binding to calcium molecules.
All of these in high concentrations can lead to acute kidney failure.
What is ATLS?
Classified as an oncologic emergency
Complication that occurs as a result of treating cancer with cell lysing/altering methods.
More common in acute and chronic leukemias because of the rapid cell proliferation.
How can we fix and/or manage ATLS?
Allopurinol: xanthine oxidase inhibitor.
Treats secondary hyperuricemia, which may occur during treatment of tumors and leukemias.
Prevents uric acid production by inhibiting xanthine oxidase, which decreases uric acid in the body.
Administered 1 to 2 days before chemotherapy in 600 to 900 mg daily doses.
Intake and output monitoring
Address the electrolyte imbalances
hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia.
How can we prevent ATLS from occurring?
Hydration is the key factor in preventing ATLS.
Fluids are administered 24-48 hours beforehand.
Monitor for fluid overload, which may lead to heart failure.
What are the clinical signs of ATLS?
Can be asymptomatic.
Fatigue, N/V, diarrhea, anorexia.
Weakness, muscle cramps.
Low urine output, edema, flank pain, hematuria, cloudy urine
VS and EKG changes.
When does ATLS occur?
Often seen in hematologic malignancies such as lymphomas and leukemia.
Occurs frequently in older adults.
Occurs less often in those with solid tumors.
Lab/Diagnostic signs of ATLS?
Uric acid levels: 4.8 to 8.7
Normal levels female: 2.4 to 6.0
Normal levels male: 3.4 to 7.0
BUN and Creatinine levels
Blood draw for serum electrolytes.
Liver function tests