{"entity":{"id":"tumor-lysis-syndrome","kind":"term","name":"Tumour lysis syndrome (TLS)","aka":[],"tldr":"When a treatment kills cancer cells faster than the body can clear their contents, flooding the blood with potassium, phosphate and uric acid and injuring the kidneys and heart. Risk is highest in bulky CLL and high-count AML, which is why venetoclax starts at a tiny dose and ramps up over weeks.","summary":"Hyperuricaemia, hyperkalaemia, hyperphosphataemia, hypocalcaemia, and acute kidney injury after rapid cell kill. Risk is highest with bulky CLL and high counts in AML. Venetoclax uses a 5-week ramp-up in CLL (20→400 mg) and a 3-day ramp in AML, with hydration, allopurinol or rasburicase, and monitoring; sonrotoclax uses a 4-week ramp.","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Tumor_lysis_syndrome","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Tumor_lysis_syndrome"},{"label":"British Committee for Standards in Haematology: guidelines for the management of tumour lysis syndrome in adults and children with haematological malignancies, British Journal of Haematology 2015","url":"https://doi.org/10.1111/bjh.13403"}],"tags":[],"related":[],"cancers":["cll","aml","all-leukemia","burkitt-lymphoma","dlbcl","non-hodgkin-lymphoma","mantle-cell-lymphoma","peripheral-t-cell-lymphoma","primary-mediastinal-b-cell-lymphoma"],"sections":[],"technologies":[],"targets":[],"drugs":["venetoclax","sonrotoclax"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["Lymphoma: the British Committee for Standards in Haematology publishes a guideline on the management of tumour lysis syndrome in adults and children with haematological malignancies. The risk is concentrated in the first days of treating bulky or fast-growing disease, which in lymphoma means Burkitt lymphoma, the high-grade B-cell lymphomas and large or rapidly growing diffuse large B-cell lymphoma, and it is the reason a pre-phase of steroid or low-dose chemotherapy, intravenous fluids, close blood monitoring and a uric-acid-lowering drug are given before full treatment begins."],"category":"Side effects"},"route":"/terms/tumor-lysis-syndrome/","neighbours":{"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"},{"id":"aml","kind":"cancer","name":"Acute myeloid leukaemia","route":"/cancers/aml/"},{"id":"aml-older-unfit","kind":"cancer","name":"Acute myeloid leukaemia in older or unfit patients","route":"/cancers/aml-older-unfit/"},{"id":"burkitt-lymphoma","kind":"cancer","name":"Burkitt lymphoma","route":"/cancers/burkitt-lymphoma/"},{"id":"cll","kind":"cancer","name":"Chronic lymphocytic leukaemia","route":"/cancers/cll/"},{"id":"cll-treatment-naive","kind":"cancer","name":"Chronic lymphocytic leukaemia, first treatment","route":"/cancers/cll-treatment-naive/"},{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"mantle-cell-lymphoma","kind":"cancer","name":"Mantle cell lymphoma","route":"/cancers/mantle-cell-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"peripheral-t-cell-lymphoma","kind":"cancer","name":"Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)","route":"/cancers/peripheral-t-cell-lymphoma/"},{"id":"plasma-cell-leukaemia","kind":"cancer","name":"Plasma cell leukaemia","route":"/cancers/plasma-cell-leukaemia/"},{"id":"primary-mediastinal-b-cell-lymphoma","kind":"cancer","name":"Primary mediastinal (thymic) large B-cell lymphoma","route":"/cancers/primary-mediastinal-b-cell-lymphoma/"}],"drug":[{"id":"sonrotoclax","kind":"drug","name":"Sonrotoclax","route":"/drugs/sonrotoclax/"},{"id":"venetoclax","kind":"drug","name":"Venetoclax","route":"/drugs/venetoclax/"}],"trial":[{"id":"cll14","kind":"trial","name":"CLL14","route":"/trials/cll14/"},{"id":"viale-a","kind":"trial","name":"VIALE-A","route":"/trials/viale-a/"}],"term":[{"id":"lymphoma-tx-tumour-lysis","kind":"term","name":"Tumour lysis syndrome in lymphoma: who is at risk, and rasburicase","route":"/terms/lymphoma-tx-tumour-lysis/"}],"target":[{"id":"xdh","kind":"target","name":"Xanthine oxidase (XDH)","route":"/targets/xdh/"}],"person":[{"id":"gertrude-elion","kind":"person","name":"Gertrude Elion","route":"/people/gertrude-elion/"}]}}