🎗️ Cairo-Bishop Tumor Lysis Syndrome
The Cairo-Bishop criteria define laboratory and clinical tumor lysis syndrome (TLS) around cytotoxic therapy.
High-risk disease (bulky/high-turnover hematologic malignancies) warrants prophylactic hydration and urate-lowering therapy before treatment (original synthesis · not guideline verbatim).
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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.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Uric acid ≥476 μmol/L or ↑25% from baseline | Yes |
|---|---|
| Potassium ≥6.0 mmol/L or ↑25% | Yes |
| Phosphate ≥1.45 mmol/L (adult) or ↑25% | Yes |
| Calcium ≤1.75 mmol/L or ↓25% | Yes |
| Clinical event present (AKI / arrhythmia / seizure) | Yes |
→DeterminationClinical TLS
- Abnormal metabolic items：4 / 4
| Uric acid ≥476 μmol/L or ↑25% from baseline | No |
|---|---|
| Potassium ≥6.0 mmol/L or ↑25% | No |
| Phosphate ≥1.45 mmol/L (adult) or ↑25% | No |
| Calcium ≤1.75 mmol/L or ↓25% | No |
| Clinical event present (AKI / arrhythmia / seizure) | No |
→DeterminationNo TLS
- Abnormal metabolic items：0 / 4
Frequently asked questions
- What is Cairo-Bishop Tumor Lysis Syndrome?
- The Cairo-Bishop criteria define laboratory and clinical tumor lysis syndrome (TLS) around cytotoxic therapy.
- How is Cairo-Bishop Tumor Lysis Syndrome calculated? What is the core formula?
- 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.
- When is Cairo-Bishop Tumor Lysis Syndrome used?
- 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.
- What are the key clinical points for Cairo-Bishop Tumor Lysis Syndrome?
- 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.
- What are the limits and cautions when using Cairo-Bishop Tumor Lysis Syndrome?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Cairo-Bishop Tumor Lysis Syndrome calculated in practice? Can you show a worked example?
- Inputs: Uric acid ≥476 μmol/L or ↑25% from baseline Yes, Potassium ≥6.0 mmol/L or ↑25% Yes, Phosphate ≥1.45 mmol/L (adult) or ↑25% Yes, Calcium ≤1.75 mmol/L or ↓25% Yes, Clinical event present (AKI / arrhythmia / seizure) Yes → Result: Determination Clinical TLS（Abnormal metabolic items: 4 / 4） Inputs: Uric acid ≥476 μmol/L or ↑25% from baseline No, Potassium ≥6.0 mmol/L or ↑25% No, Phosphate ≥1.45 mmol/L (adult) or ↑25% No, Calcium ≤1.75 mmol/L or ↓25% No, Clinical event present (AKI / arrhythmia / seizure) No → Result: Determination No TLS（Abnormal metabolic items: 0 / 4）