Emergencies in haematology: tumour lysis syndrome

Br J Haematol. 2020 Feb;188(4):494-500. doi: 10.1111/bjh.16278. Epub 2019 Nov 27.


Tumour lysis syndrome (TLS) is a significant complication of haematologic malignancies and their management. The syndrome consists of laboratory abnormalities either alone (laboratory TLS) or with clinical sequelae including renal failure, seizures, and arrhythmias (clinical TLS). Clinical TLS is a predictor for worse overall morbidity and mortality in cancer patients, but can be prevented. Thus, accurate prognostication is critical to appropriate management of patients at risk for TLS, and incorporates both disease factors (tumour type and burden) and patient factors (baseline renal insufficiency or hyperuricaemia). Strategies to prevent TLS include hydration and allopurinol in low- and intermediate-risk patients and rasburicase in high-risk patients.

Keywords: leukemia; lymphoma; renal failure; tumor lysis syndrome.

Publication types

  • Review

MeSH terms

  • Allopurinol / therapeutic use*
  • Fluid Therapy*
  • Hematologic Neoplasms / blood
  • Hematologic Neoplasms / mortality
  • Hematologic Neoplasms / therapy
  • Humans
  • Risk Factors
  • Tumor Lysis Syndrome* / blood
  • Tumor Lysis Syndrome* / mortality
  • Tumor Lysis Syndrome* / therapy


  • Allopurinol