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肿瘤溶解综合征

Tumor Lysis Syndrome

作者信息

Adeyinka Adebayo, Kaur Anahat, Bashir Khalid

机构信息

The Brooklyn Hospital Center

Charleston Area Medical Center

Abstract

Tumor lysis syndrome is a clinical condition caused by extensive tumor cell lysis and characterized by metabolic disturbances, such as hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia, which can lead to end-organ damage. This syndrome is most commonly observed in patients with hematologic malignancies. Tumor lysis syndrome is a significant metabolic and oncologic emergency commonly encountered in clinical practice. This condition can occur in both adult and pediatric oncology patients undergoing chemotherapy. The symptoms of tumor lysis syndrome primarily result from the release of intracellular substances, including potassium, phosphates, and nucleic acids, into the circulation. This release impairs the function of target organs and can lead to acute kidney injury, life-threatening arrhythmias, and potentially death. Tumor lysis syndrome typically arises following the initiation of chemotherapy, although it can also occur spontaneously in cases of high-grade hematologic malignancies characterized by substantial tumor burdens. Given the severe lethality of tumor lysis syndrome, identifying patients at increased risk and initiating early preventive measures are crucial. Prompt recognition of the renal and metabolic disturbances associated with tumor lysis syndrome and timely initiation of treatment are essential for improving patient survival.

摘要

肿瘤溶解综合征是一种由广泛的肿瘤细胞溶解引起的临床病症,其特征为代谢紊乱,如高钾血症、高磷血症、低钙血症和高尿酸血症,这些可导致终末器官损害。该综合征最常见于血液系统恶性肿瘤患者。肿瘤溶解综合征是临床实践中常见的一种严重的代谢和肿瘤急症。这种情况可发生在接受化疗的成人和儿童肿瘤患者中。肿瘤溶解综合征的症状主要源于细胞内物质(包括钾、磷酸盐和核酸)释放到循环中。这种释放会损害靶器官的功能,并可导致急性肾损伤、危及生命的心律失常,甚至可能导致死亡。肿瘤溶解综合征通常在化疗开始后出现,不过在肿瘤负荷大的高级别血液系统恶性肿瘤病例中也可能自发发生。鉴于肿瘤溶解综合征的严重致死性,识别高危患者并尽早采取预防措施至关重要。及时识别与肿瘤溶解综合征相关的肾脏和代谢紊乱并及时开始治疗对于提高患者生存率至关重要。

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