Tumor Lysis Syndrome (Cairo-Bishop grading)
Cairo-Bishop tumor lysis syndrome classifier (Cairo & Bishop, Br J Haematol 2004): counts the laboratory-TLS criteria and grades clinical TLS by creatinine, arrhythmia, and seizure.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Age class
- Adult (phosphate threshold 4.5 mg/dL)
- Uric acid
- 9 mg/dL
- Potassium
- 6.5 mEq/L
- Phosphate
- 5 mg/dL
- Corrected calcium
- 6 mg/dL
- Creatinine
- 2.4 mg/dL
- Creatinine upper limit of normal
- 1.2 mg/dL
- Cardiac arrhythmia
- None
- Seizure
- None
Result: Clinical TLS, Cairo-Bishop grade II; 4 of 4 metabolic criteria met, creatinine 2x ULN.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Laboratory TLS
- ≥ 2 of: uric acid ≥ 8, potassium ≥ 6, phosphate ≥ 4.5 adult / 6.5 pediatric, corrected calcium ≤ 7 mg/dL — each by absolute value or a 25% change from baseline.
- Clinical TLS
- Laboratory TLS plus creatinine ≥ 1.5× ULN, cardiac arrhythmia/sudden death, or seizure.
- Grade 0–V
- The maximum end-organ manifestation grade (renal by creatinine ratio; cardiac and seizure by severity).
What you enter
- Age class (sets the phosphate threshold)
- Uric acid
- Uric acid baseline
- Potassium
- Potassium baseline
- Phosphate
- Phosphate baseline
- Corrected calcium
- Calcium baseline
The other 5 fields
- Albumin (for calcium correction)
- Creatinine
- Creatinine upper limit of normal
- Cardiac arrhythmia
- Seizure
How this is calculated
Cairo MS, Bishop M. Tumor lysis syndrome: new therapeutic strategies and classification. Br J Haematol. 2004;127(1):3-11. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.