In response to a reported incident of delayed administration of rasburicase, the NHSE Patient Safety team undertook an analysis to answer the patient safety question, ‘Are there wider issues relating to delayed or omitted administration of medication to treat/prevent tumour lysis syndrome?’. Between September 2016 and January 2020, the team identified 64 relevant reported incidents, of which 16 were reported as being associated with harm.
The analysis identified several themes including a lack of staff knowledge (medical, nursing and pharmacy) around the management of tumour lysis syndrome (TLS), including the critical nature of medications to prevent/treat this complication. It also identified a lack of availability of critical medications to treat TLS at ward and pharmacy level.
Our writing group was formed in response to this analysis, to review the published literature and update the guidelines on the diagnosis and management of TLS in adults and children with a haematological malignancy with particular focus on patient safety. Where the guidance differs between adults and children, for example, medication doses or fluid infusion rates, this has been specifically stated in the text.
Declaration of Interests
The BSH paid the expenses incurred during the writing of this Guideline. All authors have made a declaration of interests to the BSH and Task Force Chairs which may be viewed on request.