Tumor lysis syndrome is best managed if anticipated and treatment is initiated prior to chemotherapy. Xanthine oxidase inhibitors (allopurinol or febuxostat) are first-line agents; treatment should begin 2 days before chemotherapy and continue for 10-14 days. Enzyme injections may also be used. One dose is usually sufficient; however, redosing should be individualized if there is an urgent need to initiate therapy in a high-bulk patient or if adequate hydration is difficult or impossible.
According to National Comprehensive Cancer Network guidelines, vigorous hydration is an essential component of the management of tumor lysis syndrome, along with treatment of hyperuricemia and frequent monitoring and aggressive correction of abnormalities. Tumor lysis syndrome is a hematologic-oncologic emergency. Untreated, the progression of tumor lysis syndrome can lead to acute kidney failure, cardiac arrhythmias, seizures, loss of muscle control, and death. Thus, prompt and aggressive treatment is essential.
Learn more about the management of tumor lysis syndrome.
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Cite this: Elwyn C. Cabebe. Fast Five Quiz: Management of Mantle Cell Lymphoma - Medscape - Nov 17, 2021.