TLS 发病率不明确,因在多数肿瘤类型中尚未对其进行准确评估或记录。在增殖率高、肿瘤负荷大与化疗敏感的恶性肿瘤中更易发。一项研究(433 例成人,322 例儿童)报道,非霍奇金氏淋巴瘤 (NHL) 中的 TLS 发病率为 6.1%,急性淋巴细胞白血病为 5.2%,急性髓系白血病为 3.4%。[3]Annemans L, Moeremans K, Lamotte M, et al. Incidence, medical resource utilisation and costs of hyperuricemia and tumour lysis syndrome in patients with acute leukaemia and non-Hodgkin's lymphoma in four European countries. Leuk Lymphoma. 2003;44:77-83.http://www.ncbi.nlm.nih.gov/pubmed/12691145?tool=bestpractice.com一项 1791 例儿童非霍奇金淋巴瘤研究显示,TLS 发生率为 4.4%(78 例)。实验室和临床 TLS 发病率可变。据报道,有证据表明,中、高风险 NHL 患者中,临床 TLS 发病率为 6%,实验室 TLS 为 42%。[2]Hande KR, Garrow GC. Acute tumor lysis syndrome in patients with high-grade non-Hodgkin's lymphoma. Am J Med. 1993;94:133-139.http://www.ncbi.nlm.nih.gov/pubmed/8430709?tool=bestpractice.com急性髓系白血病患者的诱导化疗中,临床 TLS 发病率为 5%,实验室 TLS 为 12%。[4]Montesinos P, Lorenzo I, Martin G, et al. Tumour lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model. Haematologica. 2008;93:67-74.http://www.haematologica.org/cgi/content/full/93/1/67http://www.ncbi.nlm.nih.gov/pubmed/18166787?tool=bestpractice.com[5]Cortes J, Moore JO, Maziarz RT, et al. Control of plasma uric acid in adults at risk for tumor Lysis syndrome: efficacy and safety of rasburicase alone and rasburicase followed by allopurinol compared with allopurinol alone - results of a multicenter phase III study. J Clin Oncol. 2010;28:4207-4213.http://www.ncbi.nlm.nih.gov/pubmed/20713865?tool=bestpractice.com[6]Mughal TI, Ejaz AA, Foringer JR, et al. An integrated clinical approach for the identification, prevention, and treatment of tumor lysis syndrome. Cancer Treat Rev. 2010;36:164-176.http://www.ncbi.nlm.nih.gov/pubmed/20031331?tool=bestpractice.com
TLS 可发生于任何性别、年龄或种族。高龄患者肾小球滤过率降低,发生 TLS 的风险增加。对血液恶性肿瘤及 TLS 少见的某些实体瘤(例如肾细胞癌)采用强化化疗可能促进发病率增加。[7]Nicholaou T, Wong R, Davis ID. Tumour lysis syndrome in a patient with renal-cell carcinoma treated with sunitinib malate. Lancet. 2007;369:1923-1924.http://www.ncbi.nlm.nih.gov/pubmed/17560435?tool=bestpractice.com