What is the recommended treatment for tumor lysis syndrome?

Tumor lysis syndrome (TLS) is a potentially life-threatening condition that can occur after the rapid destruction of cancer cells, leading to the release of large amounts of intracellular contents into the bloodstream. This can result in a variety of metabolic disturbances, including hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia. The management of TLS focuses on preventing these complications and addressing the metabolic abnormalities.

IV rasburicase is the most appropriate treatment for TLS as it acts by converting uric acid, which can rise dangerously high due to cell lysis, into a more soluble compound, allantoin. This significantly reduces the levels of uric acid in the blood, thereby preventing complications associated with hyperuricemia, such as acute kidney injury. Rasburicase is especially beneficial in cases where patients have high tumor burden or are at high risk for developing TLS, offering rapid and effective control of uric acid levels.

While intravenous fluids play a supportive role in management by promoting renal function and hydration, and corticosteroids may be utilized in certain malignancies to help reduce the tumor burden, they do not specifically address the metabolic derangements seen in TLS. Oral hypouricemic agents, such as allopurinol,