Frequently Asked Questions about Tumor Lysis Syndrome
- What is the incidence of tumor lysis syndrome (TLS)?
Laboratory TLS ranges from 20%-40% in different studies with clinically significant TLS ranging anywhere from 2%-10% depending on the malignancy.
- What do you do with patients who have underlying renal disease, such as patients with diabetes?
Underlying renal disease increases the patients’ risk of developing TLS from intermediate to high risk and should be managed as such.
- Is the renal damage reversible?
Often, yes, if it is caught early and dialysis is immediately initiated, restoration of normal renal function can occur. However, renal damage can also be a major contributor to long-term morbidity and early mortality. Therefore, it is most important to recognize patients at risk and take steps to prevent renal dysfunction.
- What is the shelf life of rasburicase after reconstitution?
If refrigerated, it can be used for 24 hours after reconstitution.
- Why does it seem that adults with acute myeloid leukemia have less TLS than a child with the exact same disease?
There are no data to support this statement.
- Is the pegylated form of urate oxidase used, and is it necessary?
It is neither used nor approved for use in patients with TLS.
- For what reason(s) did patients receive variable numbers of doses of rasburicase in clinical trials? Was it due to adverse effects?
These patients received variable doses of rasburicase due to investigator discretion and/or because of the design of the clinical trials.
- Which ethnic groups are at greatest risk for having G6PD deficiency?
People of African or Mediterranean descent are at the greatest risk for having G6PD deficiency.
- Why do males have a higher risk of G6PD deficiency than females?
G6PD deficiency is an X-linked disorder; females must inherit an affected gene from each parent, whereas males require only 1 affected gene.
- What is the most important parameter to measure in assessing a patient for acute kidney injury?
Urine output - How quickly after administration does rasburicase work?
Rasburicase works immediately after administration. - Can rasburicase be used for the management of gout?
Yes; however, its intravenous administration makes the use of rasburicase impractical for a chronic condition such as gout. A pegylated, long-acting form of rasburicase is under development for this purpose. - For what other reasons might healthcare professionals want to reduce uric acid levels in their patients?
Reduction of uric acid helps phosphorus excretion and reduces blood pressure.