🎗️ Cairo-Bishop Tumor Lysis Syndrome
The Cairo-Bishop criteria define laboratory and clinical tumor lysis syndrome (TLS) around cytotoxic therapy.
Cairo-Bishop Tumor Lysis Syndrome
Uric acid ≥476 μmol/L or ↑25% from baseline
Potassium ≥6.0 mmol/L or ↑25%
Phosphate ≥1.45 mmol/L (adult) or ↑25%
Calcium ≤1.75 mmol/L or ↓25%
Clinical event present (AKI / arrhythmia / seizure)
When to use
Select whether each of uric acid, potassium, phosphate, and calcium is abnormal, plus any clinical event; the tool classifies no TLS, laboratory TLS, or clinical TLS.
How it works
Laboratory TLS = ≥2 metabolic abnormalities (threshold or ±25% from baseline) from 3 days before to 7 days after therapy. Clinical TLS = laboratory TLS + AKI, arrhythmia, or seizure.
Key points
- High-risk disease (bulky/high-turnover hematologic malignancies) warrants prophylactic hydration and urate-lowering therapy before treatment (original synthesis · not guideline verbatim).
- Rasburicase is preferred over allopurinol for established hyperuricemia or high-risk patients, except in G6PD deficiency.
- Hyperphosphatemia-driven hypocalcemia should not be over-corrected with calcium because of calcium-phosphate precipitation risk.
References
- Cairo MS, Bishop M. Tumour lysis syndrome: new therapeutic strategies and classification. Br J Haematol. 2004.
- Coiffier B, et al. Guidelines for the management of pediatric and adult tumor lysis syndrome. J Clin Oncol. 2008.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.