Tumour lysis syndrome in solid tumors: Clinical characteristics and prognosis☆

Abstract Introduction and objective Tumour lysis syndrome (TLS) is an uncommon complication in solid tumours following treatment initiation, and its spontaneous development (STLS) is exceptional. In this study, we analyse the main clinical and prognostic features of a case series with TLS and STLS. Material and methods Observational retrospective study in which we included all patients with solid tumours diagnosed with TLS and STLS over a period of 16 years, according to Cairo-Bishop criteria. Results Nineteen patients were included in the study (mean age 63 ± 16 years): 10 patients (53%) with TLS, and 9 (47%) STLS. The primary tumour in 8 cases (42%) was lung cancer. All patients had severe renal impairment at the time of diagnosis along with hyperuricemia (16 ± 6 mg/dl) and hyperkalemia (6 ± 0.9 mmol/l). Despite treatment with intravenous fluids, urinary alkalinisation and rasburicase, 3 patients (16%) required dialysis, and 12 (63%) died during the follow-up period. Conclusions The development of TLS in solid tumours is associated with increased mortality and therefore, a high index of suspicion is essential for early diagnosis and treatment initiation.