It is important to prevent life threatening manifestations associated with TLS which include acute kidney injury, hyperkalemia (which may cause cardiac arrhythmias), and or hypocalcemia (which may cause cardiac arrhythmias and neuromuscular irritability). Acute Kidney Injury: Patients at risk for developing TLS (e.g. patients about to receive chemotherapy for a cancer with a high cell turnover rate, especially lymphomas and<unk> s) should receive appropriate intravenous hydration in order to improve blood flow to the kidneys, maximize urine output, and ultimately prevent precipitation of uric acid crystals that can led to acute kidney injury. A diuretic may also be indicated to further increase urine output in addition to intravenous hydration. Another approach to prevent damage to the kidneys is to prevent the build up of uric acid during TLS, and this can be accomplished with use of allopurinol or rasburicase. Allopurinol (a xanthine oxidase inhibitor, which inhibits uric acid production) works by preventing the formation of uric acid following tumor cell lysis. Rasburicase is a synthetic urate oxidase enzyme and acts by degrading uric acid. It is not recommended to alkalinize urine in the management of TLS. Hyperkalemia: Monitoring potassium levels in the blood frequently and cardiac monitoring (given the risk of cardiac arrhythmias) are important components in the prevention of adverse consequences in TLS. Other strategies include limiting oral intake of potassium and excreting potassium through the gastrointestinal tract using agents such as oral sodium polystyrene sulfonate can be beneficial. Insulin therapy (in conjunction with glucose administration) as well as beta-receptor agonists (such as albuterol) can also be used but are temporary interventions and potassium is not excreted from the body. Hemodialysis and hemofiltration can also be used as options to remove potassium from the bloodstream when hyperkalemia is present. Hypocalcemia: Hyperphosphatemia is a common finding in TLS and high phosphorus levels can itself contribute to hypocalcemia and therefore phosphate binders may be beneficial in preventing this form of hypocalcemia.
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