🧬 Tumour Lysis Syndrome (TLS) Prophylaxis
UseStratify TLS risk before chemotherapy and choose the appropriate prophylaxis tier.
SourceCairo MS, et al. Recommendations for the evaluation and management of TLS. Br J Haematol 2010
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Hydration (~3 L/m²/day) underpins all prophylaxis.
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
- [Guideline / primary source]Cairo MS, et al. Recommendations for the evaluation and management of TLS. Br J Haematol 2010
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 | Prophylaxis |
|---|
→Key pointProphylaxis (by risk)
- Hydration (cornerstone)：Vigorous IV fluids (~3 L/m²/day) to maintain urine output; all at-risk patients
- Low risk：Monitoring + hydration ± allopurinol
- Intermediate：Hydration + allopurinol (start 2–3 days before chemo, continue 7–14 days); allopurinol only prevents new uric acid
| View | Risk stratification |
|---|
→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
Verification & sources · governance
FAQ
Frequently asked questions
- 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.
- Does Tumour Lysis Syndrome (TLS) Prophylaxis upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Tumour Lysis Syndrome (TLS) Prophylaxis calculated in practice? Can you show a worked example?
- Inputs: View Prophylaxis → Result: Key point Prophylaxis (by risk)（Hydration (cornerstone): Vigorous IV fluids (~3 L/m²/day) to maintain urine output; all at-risk patients, Low risk: Monitoring + hydration ± allopurinol, Intermediate: Hydration + allopurinol (start 2–3 days before chemo, continue 7–14 days); allopurinol only prevents new uric acid） 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）