Abstract: TH-PO0204
Tumor Lysis Syndrome in Hematologic Malignancies: National Trends and In-Hospital Outcomes
Session Information
- Onconephrology: Anticancer Therapies, PTLD, Paraneoplastic Diseases, and More
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Patel, Maulinkumar N., The University of Texas Health Science Center at Houston, Houston, Texas, United States
- Doshi, Mithil, Lower Bucks Hospital, Bristol, Pennsylvania, United States
- Bhat, Adnan, University of Florida, Gainesville, Florida, United States
- Kallahalli Jayaramu, Shriharsha, University of Florida, Gainesville, Florida, United States
- Chowdhury, Raad Bin Zakir, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Jaimes, Edgar A., Memorial Sloan Kettering Cancer Center, New York, New York, United States
Background
Tumor Lysis Syndrome (TLS), a potentially fatal complication of cancer treatment, poses a significant challenge in hematologic malignancies. With the advent of novel immune therapies, concerns are rising about potential increases in TLS incidence. However, comprehensive national data on TLS trends and its complications remain limited.
Methods
We conducted a retrospective cohort study using the NIS database. From 2016 to 2022, hospitalizations with malignancies, including lymphomas, leukemias, and multiple myeloma, were identified using ICD-10 codes. TLS was defined using the ICD-10 code E88.3. We examined annual incidence trends and performed a subgroup analysis of TLS cases to evaluate outcomes, including acute kidney injury (AKI), renal replacement therapy (RRT), mortality, cardiac arrest, respiratory failure, and seizure. Logistic regression was used to assess the association between CKD stage (defined using ICD-10 codes for stages 1-5) and RRT/mortality.
Results
Among 3.87 million hematologic malignancy hospitalizations from 2016-2022, 81,805 (2.1%) had TLS. TLS incidence rose from 15.9 to 24.5 per 1,000 hospitalizations (2016–2022), with the highest rates in acute leukemias (ALL: 57.66/1,000; AML: 53.92/1,000 in 2022). In TLS cases, the incidence of AKI was 63.5%, RRT 12.9%, respiratory failure 36.8%, and in-hospital mortality 22.4% in 2022. Over time, RRT use increased slightly, while mortality remained stable. In multivariable analysis, compared to stage1/2 CKD, stage 3 (aOR 2.23, 95% CI: 1.31–3.79) and stage 4 CKD (aOR 3.35, 95% CI: 1.89–5.92) were independently associated with higher odds of RRT requirement. Higher odds of mortality were seen with the increase in CKD severity; however, not statistically significant.
Conclusion
Given rising TLS incidence and the risk associated with pre-existing CKD, standardized risk stratification and proactive management strategies are crucial for improving outcomes.