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. Learn about ways to reduce your risk of TLS in the section below. Doing so 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:

• Medicines which lower uric acid like allopurinol or febuxostat are always given when patients start venetoclax. Your doctor will monitor your uric acid levels throughout treatment. 
• Your doctor will regularly check electrolyte levels and kidney function.
• If additional hydration is needed, your healthcare team will 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 should 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.