Unveiling risk factors for tumor lysis syndrome in pediatric solid tumors: A comprehensive analysis

Tumor lysis syndrome (TLS) is a frequent oncological complication with high morbidity and mortality. The delay in recognizing risk factors and diagnosing TLS by clinicians can be fatal. This study aimed to determine the various risk factors for TLS that can be prevented in children with solid tumors, allowing for prompt prophylactic treatment of TLS. This study is a retrospective case-control study from electronic medical records of pediatric patients with solid tumors diagnosed during 2021-2022, conducted at Dr. Soetomo General Academic Hospital Surabaya. Those with TLS were in the case group, and those who did not have TLS were in the control group. The collected data is presented as descriptive data and analyzed by logistic regression with p<0.05 for the two-tail test. About 114 pediatric patients were newly diagnosed with solid tumors. Fifty patients met the inclusion criteria, of which 25 patients had TLS and 25 patients did not have TLS. The TLS prevalence in children with solid tumors reached 50%. Lactic Dehydrogenase (LDH) level (p 0.001, OR 8.5 (95%CI 2.338-30.908), was significant risk factor for TLS in children with solid tumors. Meanwhile, nutritional status, type of cancer, primary tumor size, tumor stage, and the presence of organ metastases were not significant as risk factors for the TLS occurrence in children with solid tumors. Elevated LDH level at the initial diagnosis is a significant risk factor for the development of TLS in children with solid tumors.