Question:
Tumor lysis syndrome is seen most commonly in which condition?
Tumor lysis syndrome is seen most commonly in which condition?
Show Hint
Risk Stratification for Tumor Lysis Syndrome:
- High Risk: Burkitt Lymphoma, T-cell ALL, B-ALL with WBC $\ge 100,000/\mu\text{L}$.
- Intermediate Risk: AML with WBC $\ge 25,000/\mu\text{L}$, bulky DLBCL.
- Low Risk: Hodgkin Lymphoma, CML, and most pediatric solid tumors (Wilms, Neuroblastoma).
- High Risk: Burkitt Lymphoma, T-cell ALL, B-ALL with WBC $\ge 100,000/\mu\text{L}$.
- Intermediate Risk: AML with WBC $\ge 25,000/\mu\text{L}$, bulky DLBCL.
- Low Risk: Hodgkin Lymphoma, CML, and most pediatric solid tumors (Wilms, Neuroblastoma).
Updated On: Sep 3, 2026
- Hodgkin lymphoma
- ALL
- CML
- Wilms tumor
Show Solution
Verified By Collegedunia
The Correct Option is B
Solution and Explanation
Concept:
Tumor Lysis Syndrome (TLS) occurs most frequently in hematologic malignancies characterized by high tumor burden, rapid cell proliferation rates, and exquisite chemosensitivity to cytotoxic induction therapy.
Explanation:
• Among the pediatric cancers listed, Acute Lymphoblastic Leukemia (ALL) has a high proliferative rate and large tumor burden (often presenting with marked leukocytosis, hyperleukocytosis $> 100,000/\mu\text{L}$, massive hepatosplenomegaly, and generalized lymphadenopathy).
• The rapid destruction of lymphoblasts during the initial phases of cytotoxic induction chemotherapy causes immediate release of large quantities of potassium, intracellular phosphorus, and nucleic acids (which metabolize into uric acid) into systemic circulation.
• Burkitt lymphoma and T-cell ALL have the highest overall incidence and risk stratification for spontaneous and post-treatment tumor lysis syndrome.
• Hodgkin lymphoma is a slow-growing indolent lymphoma with low tumor proliferative rate, where neoplastic Reed-Sternberg cells comprise only a small minority ($1\text{--}2\%$) of the tumor mass, making TLS exceptionally rare.
• Chronic Myeloid Leukemia (CML) is a chronic myeloproliferative disorder that progresses indolently and rarely undergoes acute massive lysis unless in accelerated or blast crisis.
• Wilms tumor is a solid renal tumor and solid tumors have a much lower cellular turnover and chemosensitivity profile, rarely precipitating acute tumor lysis syndrome.
Final Answer:
Among the given options, Acute Lymphoblastic Leukemia (ALL) is the most common cause of clinically significant tumor lysis syndrome.
Tumor Lysis Syndrome (TLS) occurs most frequently in hematologic malignancies characterized by high tumor burden, rapid cell proliferation rates, and exquisite chemosensitivity to cytotoxic induction therapy.
Explanation:
• Among the pediatric cancers listed, Acute Lymphoblastic Leukemia (ALL) has a high proliferative rate and large tumor burden (often presenting with marked leukocytosis, hyperleukocytosis $> 100,000/\mu\text{L}$, massive hepatosplenomegaly, and generalized lymphadenopathy).
• The rapid destruction of lymphoblasts during the initial phases of cytotoxic induction chemotherapy causes immediate release of large quantities of potassium, intracellular phosphorus, and nucleic acids (which metabolize into uric acid) into systemic circulation.
• Burkitt lymphoma and T-cell ALL have the highest overall incidence and risk stratification for spontaneous and post-treatment tumor lysis syndrome.
• Hodgkin lymphoma is a slow-growing indolent lymphoma with low tumor proliferative rate, where neoplastic Reed-Sternberg cells comprise only a small minority ($1\text{--}2\%$) of the tumor mass, making TLS exceptionally rare.
• Chronic Myeloid Leukemia (CML) is a chronic myeloproliferative disorder that progresses indolently and rarely undergoes acute massive lysis unless in accelerated or blast crisis.
• Wilms tumor is a solid renal tumor and solid tumors have a much lower cellular turnover and chemosensitivity profile, rarely precipitating acute tumor lysis syndrome.
Final Answer:
Among the given options, Acute Lymphoblastic Leukemia (ALL) is the most common cause of clinically significant tumor lysis syndrome.
Was this answer helpful?
0
0
Top NEET SS Paediatrics Questions
- A 2-year-old child presents with persistent fever for 4 days. Examination shows conjunctival injection and periungual desquamation, but criteria for complete Kawasaki disease are not met. You plan to evaluate for incomplete Kawasaki disease as per AHA guidelines. Which of the following investigations is NOT routinely recommended in this evaluation?
- A 27-year-old pregnant woman with systemic lupus erythematosus (SLE) is concerned about the risk of congenital heart block in her fetus due to anti-Ro/SSA antibodies. Which of the following medications is not recommended antenatally to prevent cardiac manifestations of neonatal lupus?
- A 2-week-old infant presents with a photosensitive annular erythematous rash on the face. ECG reveals complete heart block. Which is the most likely diagnosis?
- A 10-year-old child presents with arthritis involving the wrist and first MCP joint. Examination shows nail pitting. Which of the following is the most likely diagnosis?
- A 14-year-old girl with SLE presents with edema and nephrotic-range proteinuria. Renal biopsy shows diffuse thickening of the glomerular basement membrane without proliferative lesions. This corresponds to which class of lupus nephritis?
View More Questions
Top NEET SS Oncology Questions
- What is the most common site of metastasis in a child with neuroblastoma?
- On day 20 post-hematopoietic stem cell transplant (HSCT), a child develops jaundice, breathlessness, and difficulty walking. What is the most likely diagnosis?
- A 7-year-old on induction chemotherapy for ALL develops seizures. Labs: $\uparrow$phosphate, $\uparrow$uric acid, $\downarrow$calcium. What is the cause and best management?
- A patient with Burkitt lymphoma develops tumor lysis syndrome with uric acid $>$ 12 mg/dL and serum creatinine 3.5 mg/dL. What is the most appropriate next management step?
- Which is the most common brain tumor in children?
View More Questions
Top NEET SS Questions
- A liver transplant patient presents with diarrhoea, colitis, a total leukocyte count of 1800, and a positive blood CMV PCR. What is the next step in management?
- A 32-year-old male recovering from dengue fever initially showed clinical improvement but now presents with recurrence of high-grade fever, fatigue, and pancytopenia on day 10 of illness. He is hemodynamically stable with no bleeding manifestations. Which of the following investigations should be performed first to evaluate the cause of relapse and cytopenia?
- A 48-year-old man with chronic hepatitis C infection is being evaluated for risk factors associated with progression of liver disease. He has a 20-year history of infection, drinks alcohol occasionally, and has a high serum HCV RNA viral load. Which of the following factors is not associated with an increased risk of progression of liver disease in chronic HCV infection?
- A 28-year-old veterinary worker who previously received a full 3-dose pre-exposure rabies vaccination series is bitten by a stray dog while handling an animal in the clinic. The wound is cleaned immediately. What is the most appropriate post-exposure management?
- A 42-year-old patient undergoing chemotherapy for acute myeloid leukemia develops neutropenia (ANC $<$ 500) and is treated with broad-spectrum antibiotics. After initial recovery of neutrophil counts (ANC = 1500), he again develops high-grade fever and right upper quadrant abdominal pain. Imaging shows multiple small hypodense lesions in the liver and spleen. What is the most likely diagnosis?
View More Questions