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Evaluation and Treatment of Oncology Patients at Risk for Tumor Lysis Syndrome (TLS) — Assess Tumor Burden — Clinical Pathway: Inpatient, ICU, Outpatient, ED

Tumor Lysis Syndrome Clinical Pathway — Inpatient, ICU

Assess Tumor Burden

Tumor burden based on cancer/tumor characteristics.

Tumor Burden Cancer/Tumor Characteristics
Low
  • Hodgkin’s lymphoma
  • CML
Intermediate
  • AML/ALL with WBC < 100k/µl
  • Early stage Burkitt’s lymphoma/leukemia (Group A, Group B Stage 1, 2)
  • Diffuse Large B Cell Lymphoma (DLBCL) (Group A, Group B Stage 1, 2)
  • Lymphoblastic lymphoma with non-bulky disease AND LDH < 2x ULN
  • Bulky neuroblastoma or germ cell tumor
High
  • AML with WBC ≥ 100k/µl (< 100k/µl if LDH > 2x ULN
  • ALL with WBC ≥ 100k/µl (< 100k/µl if LDH > 2x ULN)
  • Advanced stage Burkitt’s lymphoma/leukemia (Group B Stage 3, 4, Group C)
  • Diffuse Large B Cell Lymphoma (DLBCL) (Group B Stage 3, 4, Group C)
  • Lymphoblastic lymphoma with bulky disease* or LDH ≥ 2x ULN
  • *bulky disease defined as Stage 3, 4 disseminated disease or with SVC syndrome or large mediastinal mass and or large pleural/pericardial effusions

Reference

The Tumor Lysis Syndrome  

 

 

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