Tumor lysis syndrome (TLS) is a complication associated with electroly
te abnormalities that is observed in patients with acute leukemia who
are receiving intense doses of chemotherapy. Forty-one patients with a
cute leukemia were treated with high-dose combination chemotherapy and
were evaluated for TLS. A grading system developed for the evaluation
of these patients was applied. Grade I tumor lysis was observed in 22
patients, grade II TLS in 2 patients and grade III in 1 patient. All
patients were treated with intravenous fluids, mannitol, allopurinol a
nd in some patients, aluminum-based antacids. Treatment for TLS prior
to intensive chemotherapy reduced morbidity and mortality associated w
ith high-dose chemotherapy for acute leukemias.