Table 1 Comparison of tumor lysis syndrome (TLS) definitions
Reference | Laboratory TLS | Clinical TLS | Other |
|---|---|---|---|
Hande & Garrow 1993[15]] | ≥2 of the following metabolic abnormalities occurring within 4 days of treatment: | Laboratory-defined TLS accompanied by any of the following: | _ |
 ○ 25% increase from baseline in UA |  ○ Creatinine level >221 μmol/l (2.5 mg/dL) | ||
 ○ 25% increase from baseline in potassium |  ○ Potassium level >6 mmol/L (6 mEq/L) | ||
 ○ 25% increase from baseline in phosphate |  ○ Calcium <1.5 mmol/L (6 mg/dL) | ||
 ○ 25% decline from baseline in calcium |  ○ Development of a life-threatening arrhythmia | ||
 ○ Sudden death | |||
Cairo & Bishop 2004 [[13]] | ≥2 of the following metabolic abnormalities occurring simultaneously within 3 days prior to and up to 7 days post-treatment initiation: | Laboratory-defined TLS accompanied by any of the following: | _ |
 ○ UA ≥476 μmol/L or 25% increase from baseline |  ○ Elevated creatinine level (≥1.5 ULN for patients >12 years of age or age-adjusted) | ||
 ○ Potassium ≥6.0 mmol/L or 25% increase from baseline |  ○ Seizures | ||
 ○ Phosphorous ≥2.1 mmol/L (children) ≥1.45 mmol/L (adults) or 25% increase from baseline |  ○ Cardiac dysrhythmia | ||
 ○ Calcium ≤1.75 mmol/L or 25% decrease from baseline |  ○ Death | ||
Howard SC, et al. 2011 [[1]] | ≥2 of the following metabolic abnormalities occurring simultaneously within 3 days prior to and up to 7 post-treatment initiation: | Laboratory-defined TLS accompanied by any of the following: | Any symptomatic hypocalcemia is diagnostic |
 ○ UA >8.0 mg/dL (475.8 μmol/L) or above ULN for age in children |  ○ Elevated creatinine | ||
 ○ level | |||
 ○ Potassium >6.0 mmol/L |  ○ Seizures | ||
 ○ Phosphorus >4.5 mg/dL (1.5 mmol/L) or >6.5 mg/dL (2.1 mmol/L) in children |  ○ Cardiac dysrhythmia | ||
 ○ Death | |||
 ○ Corrected* calcium <7.0 mg/dL (1.75 mmol/L) or ionized calcium <1.12 mg/dL (0.3 mmol/L) |