title: Risk evaluation, prophylaxis, and treatment of tumor lysis syndrome: consensus of an Italian expert panel.
abstract: BACKGROUND
  Tumor lysis syndrome (TLS) is a life-threatening complication in patients with hematological disease and/or solid tumors that results from rapid, large-scale tumor necrosis occurring spontaneously, or more commonly, as a result of chemotherapy. TLS is characterized by metabolic and electrolyte imbalances that include hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Identification of risk groups as well as early detection of TLS is crucial for the establishment of appropriate strategies of prophylaxis and treatment.
  
  
  METHODS
  A review of the peer-reviewed literature on TLS between 1990 and 2011 was conducted via a systematic search of the PubMed database using the keywords "TLS" [AND] "management," "risk evaluation," "prophylaxis," and "treatment." An expert opinion-based approach was used to review the national and international recommendations and guidelines on the topic.
  
  
  RESULTS
  The PubMed search produced 90 results, all of which were evaluated. These studies, together with a recent international consensus panel provided recommendations for evaluating the risk of TLS and providing prophylaxis. Five algorithms are presented that consider all of the factors when assessing the risk for neoplastic disease in general, and specifically for leukemia and lymphoma.
  
  
  CONCLUSIONS
  The present report provides clinicians with an easily consultable tool to guide the evidence-based management of this oncohematological emergency.
authors.affiliation: Pediatric Oncology and Hematology "Lalla Seràgnoli", Ospedale Sant'Orsola-Malpighi, Policlinico S. Orsola-Malpighi, Azienda Ospedaliera-Universitaria di Bologna, Pediatric Unit, University of Bologna, Italy. andrea.pession@unibo.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pession
authors.forename: Riccardo
authors.initials: R
authors.lastname: Masetti
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gaidano
authors.forename: Patrizia
authors.initials: P
authors.lastname: Tosi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rosti
authors.forename: Massimo
authors.initials: M
authors.lastname: Aglietta
authors.forename: Giorgina
authors.initials: G
authors.lastname: Specchia
authors.forename: Fulvio
authors.initials: F
authors.lastname: Porta
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pane
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D019317:Evidence-Based Medicine; D006801:Humans; D007558:Italy; D009369:Neoplasms / Q000188:drug therapy / Q000473:pathology*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D015275:Tumor Lysis Syndrome / Q000517:prevention & control / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents