Prevention of Tumor Lysis Syndrome in an Outpatient Setting

The prevention and identification of hyperuricemia are critical components in the management of tumor lysis syndrome (TLS), which is common in acute leukemias, large cell lymphomas, bulky tumors, large tumor burdens, and other cancers with high proliferation rates. Such cancers are very receptive to cytotoxic therapy because of increased mitotic rates. Lysis of their tumor cells results in metabolic abnormalities because of the release of their intracellular products. TLS is an oncologic emergency that could lead to renal failure and death; therefore, early identification of high-risk patients is vital for successful treatment outcomes. Treatment modalities include the use of allopurinol and hydration while implementing evidence-based practices for the prevention of TLS in the outpatient clinical center.