🧬 Tumour Lysis Syndrome (TLS) Prophylaxis
Tumour lysis syndrome (TLS) risk stratification, prophylaxis (hydration, allopurinol, rasburicase), monitoring and the Cairo-Bishop definition. Browser-side.
Hydration (~3 L/m²/day) underpins all prophylaxis.
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When to use
Stratify TLS risk before chemotherapy and choose the appropriate prophylaxis tier.
How it works
High risk > 5%, intermediate 1–5%, low < 1%. Hydration is the cornerstone; allopurinol for intermediate, rasburicase for high risk.
Key points
- Hydration (~3 L/m²/day) underpins all prophylaxis.
- Exclude G6PD deficiency before rasburicase (haemolysis).
- Do not combine rasburicase with allopurinol; do not replace asymptomatic hypocalcaemia.
- Urine alkalinisation is no longer routine.
References
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.
| View | Risk stratification |
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→Key pointTLS risk stratification (Cairo 2010)
- High (> 5%)：Burkitt/lymphoblastic lymphoma, ALL with high WBC, AML with high WBC, bulky tumour + high LDH, renal impairment/pre-existing hyperuricaemia; venetoclax initiation
- Intermediate (1–5%)：Most aggressive lymphomas, some leukaemias, moderate tumour burden
- Low (< 1%)：Most solid tumours, indolent/low-proliferation haematologic malignancies
| View | Cairo-Bishop definition |
|---|
→Key pointCairo-Bishop definition
- Laboratory TLS：Within 3 days before to 7 days after chemo, ≥ 2 abnormalities: uric acid ↑, potassium ↑, phosphate ↑, calcium ↓ (or threshold change from baseline)
- Clinical TLS：Laboratory TLS + creatinine ↑ (AKI) / arrhythmia / seizure
Frequently asked questions
- What is Tumour Lysis Syndrome (TLS) Prophylaxis?
- Tumour lysis syndrome (TLS) risk stratification, prophylaxis (hydration, allopurinol, rasburicase), monitoring and the Cairo-Bishop definition. Browser-side.
- How is Tumour Lysis Syndrome (TLS) Prophylaxis calculated? What is the core formula?
- High risk > 5%, intermediate 1–5%, low < 1%. Hydration is the cornerstone; allopurinol for intermediate, rasburicase for high risk.
- When is Tumour Lysis Syndrome (TLS) Prophylaxis used?
- Stratify TLS risk before chemotherapy and choose the appropriate prophylaxis tier.
- What are the key clinical points for Tumour Lysis Syndrome (TLS) Prophylaxis?
- Hydration (~3 L/m²/day) underpins all prophylaxis. Exclude G6PD deficiency before rasburicase (haemolysis). Do not combine rasburicase with allopurinol; do not replace asymptomatic hypocalcaemia. Urine alkalinisation is no longer routine.
- What are the limits and cautions when using Tumour Lysis Syndrome (TLS) Prophylaxis?
- 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 Tumour Lysis Syndrome (TLS) Prophylaxis calculated in practice? Can you show a worked example?
- Inputs: View Risk stratification → Result: Key point TLS risk stratification (Cairo 2010)（High (> 5%): Burkitt/lymphoblastic lymphoma, ALL with high WBC, AML with high WBC, bulky tumour + high LDH, renal impairment/pre-existing hyperuricaemia; venetoclax initiation, Intermediate (1–5%): Most aggressive lymphomas, some leukaemias, moderate tumour burden, Low (< 1%): Most solid tumours, indolent/low-proliferation haematologic malignancies） Inputs: View Cairo-Bishop definition → Result: Key point Cairo-Bishop definition（Laboratory TLS: Within 3 days before to 7 days after chemo, ≥ 2 abnormalities: uric acid ↑, potassium ↑, phosphate ↑, calcium ↓ (or threshold change from baseline), Clinical TLS: Laboratory TLS + creatinine ↑ (AKI) / arrhythmia / seizure）