Tumor Lysis Syndrome Analysis

Tumor Lysis syndrome (TLS) is characterized by rapid release of cellular components in response to chemotherapy. (Lewis, Dirksen. Heitkemper, Bucher, 2014) Chemotherapy is responsible for the destruction of cancer cell causing cells to lysis, therefore releasing the cells content into the blood stream. This content can contain potassium, phosphate, and DNA or RNA; which is metabolized by the liver to make uric acid (Lewis, Dirksen. Heitkemper, Bucher, 2014). Patient T.W. is receiving aggressive chemotherapy after being diagnosed with choriocarcinoma of the left testicle that has metastases to the neck, lung, and chest. Aggressive chemotherapy as well as the cancer spreading fast put T.W. at risk for TLS. As seen in the study by Kekre, Djordjevic,& Touchie ( 2012) the risk of TLS is related to malignancy of the cancer due to the increase in size or mass, the involvement of other organs, and the tumor lysis potential; As well as factors such as dehydration, and renal failure make the excretion of metabolites more difficult resulting in increase levels in the
To decrease T.W uric acid levels allopurinol and a fluid increase was prescribed. Allopurinol is a antihyperuricemic, it prevent the production of uric acid by inhibiting the action of the enzyme xanthine oxide (Kekre, Djordjevic,& Touchie 2012). Therefore, TW received Allopurinol in hopes to decrease the uric acid levels in the blood stream. After day 6 T.W. levels decreased with slight elevation in creatinine level of 1.24. mg/dl. Allopurinol has the potential of nephrotoxicity so monitoring renal levels is important (Vallerand, Sanoski, Deglin, 2015). We can monitor renal function by documenting input and output and monitoring labs. It is important to watch renal function to prevent increase of drugs and toxins. It is also important to also teach patients to have an alkaline diet to prevent further uric acid