Epidemiology

Incidence of tumour lysis syndrome (TLS) is unknown, as it has not been accurately assessed or documented in the majority of tumour types.

TLS is more prevalent in haematological malignancies with high proliferating rates, tumour burden, and chemosensitivity (e.g., acute lymphoblastic leukaemia and Burkitt's lymphoma).[1][8] Males and females of any age or ethnicity can be affected. Advanced age may increase the risk of developing TLS due to reduced glomerular filtration rate and the presence of comorbid conditions.[9]

One retrospective study (433 adults, 322 children) reported TLS incidence of 6.1% in non-Hodgkin's lymphoma (NHL), 5.2% in acute lymphoblastic leukaemia, and 3.4% in acute myeloid leukaemia.[10] In another study (1791 paediatric patients with NHL), 4.4% (78 patients) developed TLS, with the highest proportion occurring in those with B-cell acute lymphoblastic leukaemia (26.4%) and advanced-stage Burkitt's lymphoma (14.9%).[11] TLS occurs less frequently in multiple myeloma and the indolent haematological malignancy, chronic lymphocytic leukaemia.[4][5][6][7][12][13]

The prevalence of laboratory and clinical TLS is variable. In a study of 102 patients with intermediate- or high-grade NHL, 42% developed laboratory TLS and 6% developed clinical TLS.[14] In a study of 772 patients with acute myeloid leukaemia treated with induction chemotherapy, 12% developed laboratory TLS and 5% developed clinical TLS.[9]

There are reports of TLS in solid (non-haematological) tumours, such as renal cell cancer, breast cancer, small cell lung cancer, testicular cancer, and neuroblastoma, but they are uncommon.[15][16][17] However, with advances in cancer treatment and the increasing availability of highly effective therapies (e.g., targeted agents), the incidence of TLS is likely to increase across all malignancies, including solid tumours.[8][18][19][20]

Use of this content is subject to our disclaimer