Laboratory Tumor Lysis Syndrome Clinical Tumor Lysis Syndrome
Hyperuricemia: Uric acid > 8 mg/dL (475.8 µmol/L) in adults or above the upper limit of the normal range in children Hyperphosphatemia: Phosphorus > 4.5 mg/dL (1.5 mmol/L) in adults or > 6.5 mg/dL (2.1 mmol/L) in children Hyperkalemia: Potassium > 6 mmol/L Hypocalcemia: Corrected calcium < 7.0 mg/dl (1.75 mmol/liter) or ionized calcium < 1.12 (0.3 mmol/liter Cardiac dysrythmia or sudden death probably of definitely caused by hyperkalemia Cardiac dysrhythmia, sudden death, seizure, neuromuscular irritability (tetany, paresthesias, muscle twitching, carpopedal spasm, Trousseau’s sign, Chvostek’s sign, laryngospasm, or bronchospasm), hypotension, or heart failure probably or definitely caused by hypocalcemia Increase in the serum creatinine level of 0.3 mg/dl (26.5 μmol/liter) (or a single value >1.5 times the upper limit of the ageappropriate normal range if no baseline creatinine measurement is available) or the presence of oliguria, defined as an average urine output of < 0.5 ml/kg/hr for 6 hours
Table 2: Laboratory Tumor Lysis Syndrome and Clinical Tumor Lysis Syndrome [21].