Objective To analyze the characteristics, clinical manifestations, and management measures of tumor lysis syndrome (TLS) induced by bortezomib, and to provide reference for the safe use of bortezomib in clinical practice.

Methods The case reports related to TLS induced by bortezomib were collected from China National Knowledge Infrastructure , WanFang Data, VIP, Chinese Medical Journal Network, SinoMed, PubMed, Web of Science, Scopus, Embase, Clinicalkey and Cochrane Library, with the search period from database inception to April 10, 2026, and basic information of patients, adverse reaction occurrence, and treatment outcomes were statistically analyzed as well.

Results A total of 9 research articles involving 9 patients were included. The included patients involved 4 males and 5 females, whose age range was 34-74 years old. The primary disease of included patients was multiple myeloma, among which 5 patients had concomitant medication. All patients developed TLS within the first cycle of medication, with the highest occurrence occurring within 10 days. The main clinical manifestations included anuria or oliguria and fever, and the main abnormal indicators included creatinine, uric acid, lactate dehydrogenase, and serum phosphorus. After active treatment, the relevant indicators of 6 patients returned to normal and their conditions improved, whereas 3 patients died(2 of them died of organ failure related to TLS).

Conclusion TLS is a rare but potentially lethal adverse reaction induced by bortezomib, which should be given sufficient attention in clinical practice. This adverse reaction often occurs in the early stages of medication, and real-time monitoring of relevant indicators and clinical manifestations is beneficial for early detection. Once diagnosed, active symptomatic treatment should be administered to ensure the patient's prognosis.

1. DuttaD, LiuJ, WenK, et al. BCMA-targeted bortezomib nanotherapy improves therapeutic efficacy, overcomes resistance, and modulates the immune microenvironment in multiple myeloma[J]. Blood Cancer J, 2023, 13(1): 184. DOI: 10.1038/s41408-023-00955-y.

2. 李恒. 硼替佐米的研究进展[J]. 广州化工, 2020, 48(6): 17-19.LiH. Research progress on bortezomib[J]. Guangzhou Chemical Industry, 2020, 48(6): 17-19. DOI: 10.3969/j.issn.1001-9677.2020.06.010.

3. 伊佳, 徐德铎, 侯幸赟, 等. 硼替佐米治疗多发性骨髓瘤的临床综合评价[J]. 上海医药, 2024, 45(1): 33-38.YiJ, XuDZ, HouXY, et al. Clinical comprehensive evaluation of bortezomib in the treatment of multiple myeloma[J]. Shanghai Medical and Pharmaceutical Journal, 2024, 45(1): 33-38. DOI: 10.3969/j.issn.1006-1533.2024.01.009.

4. NijishaN, KuriachanS, KumarM, et al. Effectiveness and safety of bortezomib-dexamethasone regimen in patients with multiple myeloma: a prospective observational study[J]. Asian J Med Sci, 2024, 15(8): 67-72. DOI: 10.3126/AJMS.V15I8.66258.

5. WilsonPF, BernsSJ. Tumor lysis syndrome: new challenges and recent advances[J]. Adv Chronic Kidney Dis, 2014, 21(1): 18-26. DOI: 10.1053/j.ackd.2013.07.001.

6. WangW, DongZ, MiaoQ, et al. Anticancer drugs associated with tumor lysis syndrome: insights from the US Food and Drug Administration Adverse Event Reporting System[J]. Clin Ther, 2025, 47(10): 844-850. DOI: 10.1016/j.clinthera.2025.08.001.

7. Terzi DemirsoyE, Birtas AtesogluE, ErenN, et al. Carfilzomib-induced tumor lysis syndrome in relapsed multiple myeloma: a report of two cases[J]. Tumori, 2019, 105(6): NP24-NP27. DOI: 10.1177/0300891618793817.

8. PageMJ, McKenzieJE, BossuytPM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews[J]. Syst Rev, 2021, 10(1):89. DOI: 10.1186/s13643-021-01626-4.

9. 国家药品监督管理局. 药品不良反应报告和监测管理办法[S/OL]. (2011-05-04) [2026-05-16]. https://www.nmpa.gov.cn/yaopin/ypfgwj/ypfgbmg-zh/20110504162501325_7.html.

10. MerzA, RanH, ChiuCY, et al. Iatrogenic pneumopericardium after pericardiocentesis: a systematic review and case report[J]. J Cardiovasc Dev Dis, 2025, 12(7): 246. DOI: 10.3390/jcdd12070246.

11. FangL, PanY, ZhengH, et al. A study on predicting the efficacy of posterior lumbar interbody fusion surgery using a deep learning radiomics model[J]. Acad Radiol, 2025, 32(9): 5339-5352. DOI: 10.1016/j.acra.2025.05.026.

12. 姚叶, 李悦, 陈丽娟. 硼替佐米治疗多发性骨髓瘤致严重肿瘤溶解综合征1例[J]. 中国肿瘤临床, 2025, 52(4): 213-214.YaoY, LiY, ChenLJ. Bortezomib-induced severe tumor lysis syndrome in a patient with multiple myeloma: a case report[J]. Chinese Journal of Clinical Oncology, 2025, 52(4): 213-214. DOI: 10.12354/j.issn.1000-8179.2025.20241591.

13. 马艳飞, 戴振宇, 王迪, 等. 硼替佐米治疗复发多发性骨髓瘤致肿瘤溶解综合征1例[J]. 内科急危重症杂志, 2020, 26(3):252-253.MaYF, DaiZY, WangD, et al. Bortezomib-induced tumor lysis syndrome in a patient with relapsed multiple myeloma: a case report[J]. Journal of Internal Intensive Medicine, 2020, 26(3): 252-253. DOI: 10.11768/nkjwzzzz20200320.

14. 周惠芬, 仇惠英, 苗瞄, 等. 硼替佐米治疗多发性骨髓瘤致肿瘤溶解综合征一例[J]. 中华血液学杂志, 2007, 28(10): 654.ZhouHF, QiuHY, MiaoM, et al. Bortezomib-induced tumor lysis syndrome in a patient with multiple myeloma: a case report[J]. Chinese Journal of Hematology, 2007, 28(10): 654. DOI: 10.3760/cma.j.issn.0253-2727.2007.10.003.

15. DhanrajKM, BiswajitD. Tumor lysis syndrome in multiple myeloma treated with bortezomib[J]. J Pharmacol Pharmacother, 2014, 5(2): 161-162. DOI: 10.4103/0976-500X.130091.

16. JaskiewiczAD, HerringtonJD, WongL. Tumor lysis syndrome after bortezomib therapy for plasma cell leukemia[J]. Pharmacotherapy, 2005, 25(12): 1820-1825. DOI: 10.1592/phco.2005.25.12.1820.

17. LipsteinM, O'ConnorO, MontanariF, et al. Bortezomib-induced tumor lysis syndrome in a patient with HIV-negative plasmablastic lymphoma[J]. Clin Lymphoma Myeloma Leuk, 2010, 10(5): E43-E46. DOI: 10.3816/CLML.2010.n.074.

18. FurtadoM, RuleS. Bortezomib-associated tumor lysis syndrome in multiple myeloma[J]. Leuk Lymphoma, 2008, 49(12): 2380-2382. DOI: 10.1080/10428190802484099.

19. TerposE, PolitouM, RahemtullaA. Tumour lysis syndrome in multiple myeloma after bortezomib (VELCADE) administration[J]. J Cancer Res Clin Oncol, 2004, 130(10): 623-625. DOI: 10.1007/s00432-004-0593-4.

20. ChimCS. Rapid complete remission in multiple myeloma with bortezomib/thalidomide/dexamethasone combination therapy following development of tumor lysis syndrome[J]. Cancer Chemother Pharmacol, 2008, 62(1): 181-182. DOI: 10.1007/s00280-007-0574-9.

21. San MiguelJ, BladéJ, BoccadoroM, et al. A practical update on the use of bortezomib in the management of multiple myeloma[J]. Oncologist, 2006, 11(1): 51-61. DOI: 10.1634/theoncologist.11-1-51.

22. GeraldesC, RoqueA, Sarmento-RibeiroAB, et al. Practical management of disease-related manifestations and drug toxicities in patients with multiple myeloma[J]. Front Oncol, 2024, 14:1282300. DOI: 10.3389/fonc.2024.1282300.

23. AlqurashiRM, TamimHH, AlsubhiZD, et al. Tumor lysis syndrome in patients with solid tumors: a systematic review of reported cases[J]. Cureus, 2022, 14(10): e30652. DOI: 10.7759/cureus.30652.

24. NiesvizkyR, RichardsonPG, SonneveldP, et al. Relationship between quality of response to bortezomib (btz) and clinical benefit in multiple myeloma (MM) in the APEX and SUMMIT studies[J]. Blood, 2006, 108(11): 3529. DOI: 10.1182/blood.v108.11.3529.3529.

25. SogbeinO, PaulP, UmarM, et al. Bortezomib in cancer therapy: Mechanisms, side effects, and future proteasome inhibitors[J]. Life Sci, 2024, 358: 123125. DOI: 10.1016/j.lfs.2024.123125.

26. JaskiewiczAD, HerringtonJD. Tumor lysis syndrome early after treatment with bortezomib for multiple myeloma[J]. Pharmacotherapy, 2006, 26(8): 1206. DOI:10.1592/phco.26.8.1205.

27. ZelenetzAD, GordonLI, AbramsonJS, et al. NCCN Guidelines® insights: B-cell lymphomas 3.2025[J]. J Natl Compr Canc Netw, 2025, 23(10): e250048. DOI: 10.6004/jnccn.2025.0048.