McBride Ali, Trifilio Steven, Baxter Nadine, Gregory Tara K, Howard Scott C
The University of Arizona Cancer Center, Tucson, Arizona.
Northwestern Memorial Hospital, Chicago, Illinois.
J Adv Pract Oncol. 2017 Nov-Dec;8(7):705-720. Epub 2017 Nov 1.
Tumor lysis syndrome (TLS) is a potentially life-threatening emergency that can develop rapidly after the release of intracellular contents from lysed malignant cells. The advent of novel and targeted therapies that have improved tumor-killing efficacy has the potential to increase the risk of TLS when used as part of front-line therapy. A recent review of TLS risk in patients with hematologic malignancies treated with newer targeted agents highlighted the need to revisit TLS risk stratification and to describe the practical challenges of TLS prevention, treatment, and monitoring. Although this era of rapid development of novel cancer therapies provides new hope for patients with hematologic malignancies, it is essential to be prepared for TLS because monitoring and prophylaxis can almost always prevent severe and life-threatening consequences. Heightened awareness of the development of TLS with novel and targeted agents, accompanied by aggressive hydration and rational, risk-appropriate management, are the keys to successful outcomes.
肿瘤溶解综合征(TLS)是一种潜在的危及生命的紧急情况,可在裂解的恶性细胞释放细胞内成分后迅速发生。新型靶向疗法提高了肿瘤杀伤效果,但作为一线治疗的一部分使用时,有可能增加TLS的风险。最近一项关于使用新型靶向药物治疗的血液系统恶性肿瘤患者TLS风险的综述强调,有必要重新审视TLS风险分层,并描述TLS预防、治疗和监测的实际挑战。尽管新型癌症疗法的快速发展为血液系统恶性肿瘤患者带来了新希望,但由于监测和预防几乎总能预防严重和危及生命的后果,因此对TLS做好准备至关重要。提高对新型靶向药物引发TLS的认识,同时积极补液并进行合理、符合风险的管理,是取得成功结果的关键。