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Pretreatment of Tumor Lysis Syndrom

Pretreatment for patients identified at high risk for TLS:

  • Administer intravenous (IV) normal saline (and diuretics if necessary) to achieve urine output of 2 mL/kg/hr (often sufficient for mild TLS).

  • If hyperuricemia is present, an agent to reduce uric acid may be required (either allopurinol or rasburicase). Although rasburicase has been shown to be more effective (and preferred in the presence of renal injury), it is very expensive.