A client recently treated for non-Hodgkin's lymphoma is being monitored at home. Which complication should be assessed?

• A. Syndrome of inappropriate antidiuretic hormone (SIADH)
• B. Disseminated intravascular coagulation (DIC)
• C. Hypercalcemia
• D. Tumor lysis syndrome

Answer: (D)

Rapid tumor cell breakdown after chemotherapy in non-Hodgkin lymphoma can trigger tumor lysis syndrome, a dangerous spread of intracellular contents into the bloodstream. This rush releases potassium and phosphate, raises uric acid, and lowers calcium, leading to electrolyte imbalance and possible kidney injury. It’s a classic complication when a high tumor burden is treated aggressively because many cancer cells die quickly and release their contents all at once.

Because this patient is monitored at home, watch for signs of TLS such as decreased urine output, flank or back pain, swelling, nausea or vomiting, confusion, or muscle cramps. These symptoms suggest electrolyte disturbances or kidney problems and require urgent medical assessment. Prevention and management focus on aggressive hydration, monitoring and correcting electrolytes, and using uric acid–lowering therapy as prescribed (for example, allopurinol or rasburicase) to protect kidney function. While other cancer-related issues can occur, TLS is the most anticipated complication after treatment in patients with a high tumor burden.