Tumor lysis syndrome in chilhood malignancies

Tumor lysis syndrome is a very serious and sometimes life-threatening complication of cancer therapy. . It can be defined as a constellation of metabolic abnormalities resulting from spontaneous or treatment-related tumor necrosis or fulminant apoptosis.Tumor lysis syndrome (TLS) can be precipitated before the initiation of therapy and usually lasts up to 3 days after the start of chemotherapy, especially with tumors that have a high growth fraction and high sensitivity to chemotherapy. Burkitt’s lymphoma and T cell acute lymphoblastic leukemia are most frequently associated with this complication.Lysis of tumor cells results in rapid release of potassium, purine nucleic acids, and phosphorus, which leads to hyperkalemia, hyperuricemia, and hyperphosphatemia with secondary hypocalcemia. These metabolic abnormalities can subsequently lead to acute renal failure (ARF). These complications may result in multiple organ failure and death .Successful management and treatment of tumor lysis syndrome is highly dependent on the prompt identification of clinical and laboratory characteristics, signs and symptoms of patients at risk. Establishment of vascular access and the initiation of prophylactic measures, especially hydration and administration of allopurinol or rasburicase, are vital. The early recognition and treatment of metabolic abnormalities usually prevents the severe and life-threatening complications associated with tumor lysis syndrome.Rasburicase is a potent drug with potential advantages,and isa potent and rapid approach for prevention and treatment of TLS.