Tümör lizis sendromu; tanı, izlem ve tedavide yeni yaklaşımlar

Celkan, Tiraje; Tüysüz, Gülen
September 2013
Turkish Pediatrics Archive / Turk Pediatri Arsivi;sep2013, Vol. 48 Issue 3, p188
Academic Journal
Tumor lysis syndrome is a clinical situation which occurs with the lysis of malignant cells and causes metabolic abnormalities that threatens life. These metabolic abnormalities are caused by the release of intracellular ions, nucleic acids, proteins and their metabolites from the instant degraded tumor cells. These fast released metabolites can blemish the body's normal homeostatic mechanism and cause uraemia, hyperuricaemia, hyperkalaemia and hyperphosphaetemia. Hypocalcaemia, which is commonly seen in tumor lysis syndrome is seconder to hyperphosphaetemia. Generally, tumor lysis syndrome occurs after the initiation of chemotherapy but rarely it is observed in fast growing tumours before the treatment duty to spontaneous lysis of malignant cells. There is a high incidence of tumor lysis syndrome in tumours with high proliferative rates and tumour burden like Burkitt's lymphoma and acute lymphoblastic leukemia. The principle of tumour lysis syndrome, prophylaxis/treatment includes virgous hydration, adequate diuresis, control of hyperuricemia with rasburicase or allopurinol, regulation of serum electrolytes and dialysis should be the treatment options. If the necessary measures are not taken or the clinal situation is not treated properly, metabolic abnormalities can cause renal insufficiency, cardiac arythmia, neurologic complications and probably sudden death in patients with cancer. Alkalisation of urine was applied to all patients previously, but it is not any longer recommended, and this issue is still open to debate. In this paper, new approaches and innovations in the treatment of tumor lysis syndrome are discussed.


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