Department of Internal Medicine & Systemic Pathologies, Ospedale Cannizzaro, Viale Messina, 829-95125 Catania, Italy.
Expert Rev Hematol. 2012 Feb;5(1):27-38. doi: 10.1586/ehm.11.73.
Tumor lysis syndrome (TLS) is a common oncologic emergency in patients with hematological malignancies sensitive to cytotoxic treatment that present a high proliferative rate. High proliferative cancer rate, high sensitivity of cytotoxic treatment and renal failure represent risk factors for development of TLS. TLS is also responsible for several electrolytic alterations, such as hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. There are different established therapeutic options for the treatment of TLS such as hydration, allopurinol and rasburicase. Rasburicase reduces uric acid levels within 4 h, both in pediatric and adult patients, catalyzing the oxidation of uric acid into allantoin, rapidly excreted by the kidneys. Rasburicase is well tolerated and was approved in the EU and in the USA for the management of acute hyperuricemia.
肿瘤溶解综合征(TLS)是对细胞毒性治疗敏感的血液系统恶性肿瘤患者中常见的肿瘤急症,这些患者具有较高的增殖率。高增殖性肿瘤率、细胞毒性治疗的高敏感性和肾衰竭是 TLS 发展的危险因素。TLS 还会导致多种电解质紊乱,如高尿酸血症、高钾血症、高磷血症和低钙血症。目前已经有多种治疗 TLS 的方法,例如水化、别嘌醇和拉布立酶。拉布立酶可在 4 小时内降低尿酸水平,在儿科和成人患者中均有效,通过催化尿酸氧化为别嘌呤醇,从而迅速由肾脏排泄。拉布立酶耐受性良好,已在欧盟和美国获批用于治疗急性高尿酸血症。