When prophylaxis recommended for Tumor lysis syndrome?
Clinical judgment should be used to categorize patients as either low or high risk. Risk assessment should take into account the whole patient, keeping in mind the presence or absence of underlying kidney compromise, the type of malignancy, the tumor burden, and the prescribed chemotherapy.
In general, patients at high risk have one or more of the risk factors described previously. Patients at low risk should receive intravenous hydration and allopurinol.
Patients at high risk for TLS may receive intravenous hydration and rasburicase.
Allopurinol and rasburicase are not given together because allopurinol blocks xanthine oxidase, thus decreasing the substrate for rasburicase.
