Risk Factors For The Development Of

A large tumor burden with rapid cell turnover, elevated LDH, preexisting hyperuricemia, sensitivity of tumors to chemotherapy, and abnormal baseline renal function, predispose to an increased risk of TLS.1 Tumor cell type is also an important determinant in assessing risk. TLS is most frequently encountered in aggressive lymphomas, especially the Burkitt's type.2-7 Among the other hematological malignancies, T-cell ALL has the highest risk of TLS,8 followed by chronic leukemias9-11 and other indolent lymphomas.1213 Most often, TLS is observed in the setting of systemic chemotherapy, but spontaneous occurrences are reported.213 In addition, TLS can occur in response to a variety of other therapies, such as corti-costeroids,3'4'12'14 intrathecal methotrexate,15-17 tamoxifen, total body radiation,18 imatinib mesy-late,19 and monoclonal antibodies such as rituximab 620 and gemtuzumab ozogamicin.21

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