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i3 Health

Current Standards and Best Practices in the Management of Tumor Lysis Syndrome

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Overview / Abstract:


Tumor lysis syndrome (TLS) is a rare, potentially life-threatening oncologic emergency typically associated with chemotherapy-induced tumor cell death in which potassium, phosphate, and nucleic acids are released into the bloodstream. This release of intracellular materials results in severe metabolic abnormalities such as hyperuricemia and hyperphosphatemia, which may cause acute renal injury, and hypokalemia and hypocalcemia, which may cause seizures, neuromuscular symptoms, and cardiac arrhythmias. The occurrence of TLS may prevent or delay the administration of potentially life-saving chemotherapy. Furthermore, the kidney damage, heart failure, fluid retention, and neuromuscular and gastrointestinal effects caused by TLS may lead to reductions in chemotherapy dosing and alter the selection of cytotoxic agents. The most effective management strategy is prevention; however, despite appropriate prophylactic measures, approximately 3% to 5% of high-risk patients receiving chemotherapy are affected. The overall mortality rate of patients with TLS is 15%.


Hematology/oncology physicians, hematology/oncology fellows, oncology advanced practitioners, oncology nurses, and other health care professionals involved in the treatment of cancer patients at risk for TLS.


Upon completion of this activity, participants should be able to:

1. Assess the risk for TLS in patients receiving current and emerging therapies for hematologic malignancies
2. Differentiate the signs and symptoms of TLS
3. Evaluate evidence-based strategies for the prevention and treatment of TLS

Note: The learning objectives listed above apply to nurse practitioners and registered nurses in addition to physicians.


Jul 31, 2020


Nurse Practitioner , Nursing CNE, Physician CME, Physician Assistant CME


Monograph, Online

Credits / Hours




Presenters / Authors / Faculty

Anthony R. Mato, MD, MSCE (Chairperson)
Associate Professor of Medicine
Memorial Sloan Kettering Cancer Center

Colleen Dorsey, RN, BSN
Registered Nurse
Memorial Sloan Kettering Cancer Center

Sponsors / Supporters / Grant Providers

This activity is supported by an independent educational grant from Sanofi Genzyme.

Keywords / Search Terms

i3 Health i3 Health, TLS, tumor lysis syndrome, oncologic emergencies, hematology, free CME, free CE, online CME, online CE, supportive care Free CE CME

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