29th December 2024

Overview of TLS

TLS is a syndrome characterised by biochemical and metabolic derangement driven by the rapid breakdown of tumour cells, causing the release of intracellular contents into the circulatory system. It is typically triggered by delivery of chemotherapy, however may also occur after any systemic anti-cancer treatment (SACT), after radiotherapy in radio-sensitive tumours, and even spontaneously in patients with a large tumour burden.

This is an emergency presentation, as the resultant renal impairment and electrolyte abnormalities can limit treatment options and can even result in death. It is crucial to identify TLS early, so that emergency treatment can be initiated, and also to identify patients at risk who may need prophylactic treatment and close monitoring.