![]() Because of the hyperphosphatemia, calcium is precipitated to form calcium phosphate, leading to hypocalcemia. Hyperphosphatemia causes acute kidney injury in tumor lysis syndrome, because of deposition of calcium phosphate crystals in the kidney parenchyma. Like potassium, phosphates are also predominantly intracellular. ![]() palpitations, cardiac conduction abnormalities, and arrhythmias (can be fatal).Symptoms usually do not manifest until levels are high (> 6.5 mmol/L) and they include High turnover of tumor cells leads to spill of potassium into the blood. Potassium is mainly an intracellular ion. The metabolic abnormalities seen in tumor lysis syndrome can ultimately result in serious complications such as acute uric acid nephropathy, acute kidney failure, seizures, cardiac arrhythmias, and death. In TLS, the breakdown occurs after cytotoxic therapy or from cancers with high cell turnover and tumor proliferation rates. In this respect, TLS is analogous to rhabdomyolysis, with comparable mechanism and blood chemistry effects but with different cause. ![]() These changes in blood electrolytes and metabolites are a result of the release of cellular contents of dying cells into the bloodstream. Tumor lysis syndrome is characterized by high blood potassium ( hyperkalemia), high blood phosphate ( hyperphosphatemia), low blood calcium ( hypocalcemia), high blood uric acid ( hyperuricemia), and higher than normal levels of blood urea nitrogen ( BUN). TLS can also occur on its own (while not being treated with chemotherapy) although this is less common. This is a potentially fatal complication and patients at increased risk for TLS should be closely monitored while receiving chemotherapy and should receive preventive measures and treatments as necessary. This occurs most commonly after the treatment of lymphomas and leukemias and in particular when treating non-Hodgkin lymphoma, acute myeloid leukemia, and acute lymphoblastic leukemia. Tumor lysis syndrome ( TLS) is a group of metabolic abnormalities that can occur as a complication from the treatment of cancer, where large amounts of tumor cells are killed off ( lysed) from the treatment, releasing their contents into the bloodstream. ![]()
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