Epidemiology

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

TLS is more prevalent in hematologic malignancies with high proliferating rates, tumor burden, and chemosensitivity (e.g., acute lymphoblastic leukemia and Burkitt lymphoma).[1][12] 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.[13]

One retrospective study (433 adults, 322 children) reported TLS incidence of 6.1% in non-Hodgkin lymphoma (NHL), 5.2% in acute lymphoblastic leukemia, and 3.4% in acute myeloid leukemia.[14] In another study (1791 pediatric patients with NHL), 4.4% (78 patients) developed TLS, with the highest proportion occurring in those with B-cell acute lymphoblastic leukemia (26.4%) and advanced-stage Burkitt lymphoma (14.9%).[15] TLS occurs less frequently in multiple myeloma and the indolent hematologic malignancy, chronic lymphocytic leukemia.[8][9][10][11][16][17]

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.[18] In a study of 772 patients with acute myeloid leukemia treated with induction chemotherapy, 12% developed laboratory TLS and 5% developed clinical TLS.[13]

There are reports of TLS in solid (non-hematologic) tumors, such as renal cell cancer, breast cancer, small cell lung cancer, testicular cancer, and neuroblastoma, but they are uncommon.[19][20][21] 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 tumors.[12][22][23][24]

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