Lupușoru Gabriela, Ailincăi Ioana, Frățilă Georgiana, Ungureanu Oana, Andronesi Andreea, Lupușoru Mircea, Banu Mihaela, Văcăroiu Ileana, Dina Constantin, Sinescu Ioanel
Department of Nephrology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Nephrology, Fundeni Clinical Institute, 022328 Bucharest, Romania.
Biomedicines. 2022 Apr 28;10(5):1012. doi: 10.3390/biomedicines10051012.
Tumor lysis syndrome (TLS) is a common cause of acute kidney injury in patients with malignancies, and it is a frequent condition for which the nephrologist is consulted in the case of the hospitalized oncological patient. Recognizing the patients at risk of developing TLS is essential, and so is the prophylactic treatment. The initiation of treatment for TLS is a medical emergency that must be addressed in a multidisciplinary team (oncologist, nephrologist, critical care physician) in order to reduce the risk of death and that of chronic renal impairment. TLS can occur spontaneously in the case of high tumor burden or may be caused by the initiation of highly efficient anti-tumor therapies, such as chemotherapy, radiation therapy, dexamethasone, monoclonal antibodies, CAR-T therapy, or hematopoietic stem cell transplantation. It is caused by lysis of tumor cells and the release of cellular components in the circulation, resulting in electrolytes and metabolic disturbances that can lead to organ dysfunction and even death. The aim of this paper is to review the scientific data on the updated definition of TLS, epidemiology, pathogenesis, and recognition of patients at risk of developing TLS, as well as to point out the recent advances in TLS treatment.
肿瘤溶解综合征（TLS）是恶性肿瘤患者急性肾损伤的常见原因，也是住院肿瘤患者常因该病症而咨询肾病科医生的情况。识别有发生TLS风险的患者至关重要，预防性治疗同样如此。TLS治疗的启动是一种医疗紧急情况，必须由多学科团队（肿瘤学家、肾病学家、重症监护医生）进行处理，以降低死亡风险和慢性肾功能损害风险。TLS可在肿瘤负荷高的情况下自发发生，也可能由高效抗肿瘤治疗的启动引起，如化疗、放疗、地塞米松、单克隆抗体、嵌合抗原受体T细胞（CAR-T）疗法或造血干细胞移植。它是由肿瘤细胞溶解以及细胞成分在循环中释放所致，导致电解质和代谢紊乱，进而可引起器官功能障碍甚至死亡。本文旨在综述关于TLS更新定义、流行病学、发病机制以及识别有发生TLS风险患者的科学数据，并指出TLS治疗的最新进展。
