Pediatric Oncology and Hematology "Lalla Seràgnoli", Ospedale Sant'Orsola-Malpighi, Policlinico S. Orsola-Malpighi, Azienda Ospedaliera-Universitaria di Bologna, Pediatric Unit, University of Bologna, Italy.
Adv Ther. 2011 Aug;28(8):684-97. doi: 10.1007/s12325-011-0041-1. Epub 2011 Jul 15.
Tumor lysis syndrome (TLS) is a life-threatening complication in patients with hematological disease and/or solid tumors that results from rapid, large-scale tumor necrosis occurring spontaneously, or more commonly, as a result of chemotherapy. TLS is characterized by metabolic and electrolyte imbalances that include hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Identification of risk groups as well as early detection of TLS is crucial for the establishment of appropriate strategies of prophylaxis and treatment.
A review of the peer-reviewed literature on TLS between 1990 and 2011 was conducted via a systematic search of the PubMed database using the keywords "TLS" [AND] "management," "risk evaluation," "prophylaxis," and "treatment." An expert opinion-based approach was used to review the national and international recommendations and guidelines on the topic.
The PubMed search produced 90 results, all of which were evaluated. These studies, together with a recent international consensus panel provided recommendations for evaluating the risk of TLS and providing prophylaxis. Five algorithms are presented that consider all of the factors when assessing the risk for neoplastic disease in general, and specifically for leukemia and lymphoma.
The present report provides clinicians with an easily consultable tool to guide the evidence-based management of this oncohematological emergency.
肿瘤溶解综合征（TLS）是一种危及生命的并发症，发生于血液系统疾病和/或实体瘤患者，是由于肿瘤自发性快速、大规模坏死引起的，更常见的是由于化疗引起的。TLS 的特征是代谢和电解质失衡，包括高尿酸血症、高钾血症、高磷血症和低钙血症。识别风险群体以及早期发现 TLS 对于制定适当的预防和治疗策略至关重要。
通过系统地在 PubMed 数据库中使用关键字“TLS”[和]“管理”、“风险评估”、“预防”和“治疗”，对 1990 年至 2011 年期间关于 TLS 的同行评议文献进行了回顾。采用基于专家意见的方法审查了关于该主题的国家和国际建议和指南。
PubMed 搜索产生了 90 个结果，所有这些结果都进行了评估。这些研究以及最近的国际共识小组为评估 TLS 风险和提供预防措施提供了建议。提出了五个算法，这些算法在评估一般肿瘤疾病的风险时考虑了所有因素，特别是白血病和淋巴瘤。
本报告为临床医生提供了一个便于查阅的工具，以指导这种肿瘤血液病急症的循证管理。
