What monitoring protocols should be implemented for patients at risk of Tumour Lysis Syndrome during their treatment regimen?

Patients at risk of tumour lysis syndrome (TLS) during their treatment regimen should undergo rigorous and frequent monitoring of biochemical parameters to detect early metabolic disturbances. This includes baseline and serial measurements of serum electrolytes (potassium, phosphate, calcium), uric acid, creatinine, and lactate dehydrogenase (LDH) before and throughout treatment, with monitoring frequency tailored to the individual risk level and treatment phase ³.

Close monitoring should begin prior to initiating cytotoxic therapy and continue at least daily during the highest risk period, typically the first 72 hours after treatment initiation, to promptly identify hyperkalaemia, hyperphosphataemia, hypocalcaemia, and rising uric acid levels (Tambaro and Wierda, 2020). Renal function should be assessed frequently to detect acute kidney injury early, as this is a critical complication of TLS ³.

In addition to laboratory monitoring, clinical assessment for signs of TLS such as arrhythmias, seizures, or fluid overload is essential. Prophylactic measures including aggressive hydration and urate-lowering therapy should be guided by risk stratification and ongoing monitoring results ³ (Tambaro and Wierda, 2020). The integration of UK haematological cancer guidelines with recent literature emphasizes the importance of a multidisciplinary approach to monitoring, involving oncology, nephrology, and nursing teams to ensure timely intervention ³ (Tambaro and Wierda, 2020).