What is Tumor Lysis Syndrome?

Tumor lysis syndrome (TLS) is a rare but potentially life-threatening complication that occurs when cancer cells release their contents into the bloodstream faster than the body can process them, usually after starting cancer treatments.

This rapid release includes substances like potassium, phosphates, and nucleic acids, leading to metabolic imbalances that can cause kidney dysfunction or failure, irregular heartbeat, and seizures. Other symptoms of TLS may include fever, chills, nausea, vomiting, confusion, shortness of breath, dark or cloudy urine, and unusual fatigue.

In CLL, treatments like venetoclax, obinutuzumab, and CAR T-cell therapy can trigger TLS by killing large numbers of cancer cells quickly. Learning about ways to reduce your risk of TLS before starting treatment can help improve your overall experience. Your healthcare team will also monitor for signs of TLS and provide supportive care as needed.

How is Tumor Lysis Syndrome Managed? 

To help prevent or reduce the risk of tumor lysis syndrome (TLS), be aware of the following:

• Your doctor will monitor your uric acid levels and may prescribe medication, like allopurinol, to lower uric acid.
• Electrolyte levels and kidney function will be regularly checked by your doctor.
• If additional hydration is needed, your healthcare team may provide intravenous (IV) fluids.
• If you are at high risk for TLS, such as having a high tumor burden or a pre-existing kidney condition, you may be hospitalized for close monitoring before starting treatment.
• Stay hydrated by drinking 6-8 glasses of water each day, as this can lower your risk of TLS.
• Be sure to discuss any other medications you are taking with your doctor, as some drug interactions can increase the risk of developing TLS.