TLS should be suspected in patients with large tumor burden who develop<unk>  kidney failure along with hyperuricemia (> 15 mg/dL) or hyperphosphatemia (> 8 mg/dL). (Most other<unk>  kidney failure occurs with uric acid 1.0, compared to a value of 0.6–0.7 for most other causes of<unk>  kidney failure. Cairo-Bishop definition In 2004, Cairo and Bishop defined a classification system for tumor lysis syndrome. * Laboratory tumor lysis syndrome: abnormality in two or more of the following, occurring within three days before or seven days after chemotherapy. * uric acid > 8 mg/dL or 25% increase * potassium > 6 meq/L or 25% increase * phosphate > 4.5 mg/dL or 25% increase * calcium < 7 mg/dL or 25% decrease * Clinical tumor lysis syndrome: laboratory tumor lysis syndrome plus one or more of the following: * increased serum creatinine (1.5 times upper limit of normal) * cardiac arrhythmia or sudden death * seizure A grading scale (0–5) is used depending on the presence of lab TLS, serum creatinine, arrhythmias, or seizures. Howard definition In 2011, Howard proposed a refinement of the standard Cairo-Bishop definition of TLS accounting for 2 limitations: * Two or more electrolyte laboratory abnormalities must be present simultaneously to be considered related to TLS. In fact, some patients may present with one abnormality, but later another one may develop that is unrelated to the TLS (e.g., hypocalcemia associated with sepsis). * A 25% change from baseline should not be considered a criterion since such increases are rarely clinically important unless the value is already outside the normal range. Moreover, any symptomatic hypocalcemia should constitute clinical TLS.
complications of Acute lymphoblastic leukemia
complications of Agranulocytosis
symptom of Acute myeloid leukemia
symptoms of Aplastic anemia
symptom of Aplastic anemia
types of Acute lymphoblastic leukemia
medical cause of Neutropenia
symptom of Myelodysplastic syndrome