Efficacy of Single Low-Dose Rasburicase in Management of Tumor Lysis Syndrome in Leukemia and Lymphoma Patients

Gupta, Gopila; Seth, Tulika; Garg, Vikas; Juneja, Richa; Mahapatra, Manoranjan; Datta, Sudip Kumar; Upadhyay, Ashish Datt; Saxena, Renu

doi:10.1016/j.clml.2020.08.024

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…2 Rasburicase was spiked at a lower concentration than the product characteristics document 2 and NICE 1 recommended 200 μg/kg due to widespread use of a lower dose of rasburicase including at our centre. 11,12 After thorough mixing, serum was pipetted in one tube each of plain (no additive, Greiner item 454001) and tripotassium-EDTA (Greiner item 454086), and two FC Mix tubes (Greiner item 454510) to the recommended volume and mixed by inversions as per Greiner tube recommendation. Additionally, a pre-chilled (ice-water) lithium heparin tube was spiked with the same concentration of rasburicase.…”

Section: Methodsmentioning

confidence: 99%

Acid freezes uricolysis in addition to glycolysis: Utility of fluoride-EDTA-citrate tube in the measurement of uric acid for patients administered rasburicase

et al. 2022

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Background In samples from patients administered rasburicase, ex vivo uricolysis leads to spuriously low uric acid results. The manufacturer’s recommendation of storing the sample in ice-water until analysis, however, does not fully arrest uricolysis. Since uricase activity is affected by pH and metal chelators, we assessed uricolysis inhibition in sodium fluoride-ethylenediaminetetraacetic acid (EDTA)-citrate sample tube (FC Mix tube, Greiner) used primarily for plasma glucose. Method A serum pool was spiked with rasburicase and uric acid measured at 15, 45, 90, 150, 240 and 1080 min in a lithium heparin tube in ice-water, plain tube at room temperature (RT), EDTA tube at RT, FC Mix tube in ice-water, FC Mix tube at RT and FC Mix tube at RT prepared by dissolving FC Mix in serum. Results The rate of urate decay was lowest in the FC Mix tube independent of temperature, then lithium heparin tube in ice-water, then EDTA tube at RT and highest in the plain tube at RT. Uric acid concentrations in the prepared FC Mix tube at RT and heparin tube in ice-water were, respectively, 98.2% and 93.8% of control values at 90 min, 97.1% and 89.3% of control values at 4 h, and remained higher in the prepared FC Mix tube at all time points. Conclusion NaF-EDTA-citrate mixture largely arrested rasburicase mediated ex vivo uricolysis without the need for sample cooling. We propose that sample tubes containing NaF-EDTA-citrate be used for the measurement of uric acid in patients administered rasburicase.

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Section: Methodsmentioning

confidence: 99%

Acid freezes uricolysis in addition to glycolysis: Utility of fluoride-EDTA-citrate tube in the measurement of uric acid for patients administered rasburicase

et al. 2022

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“…Previously conducted clinical trials have demonstrated the superiority of rasburicase compared to allopurinol in producing a steep and rapid decrease in plasma uric acid concentrations in pediatric patients with TLS [ 18 – 20 ]. A single low-dose of rasburicase has shown effectiveness in pediatric patients with NHL and AL in the management of TLS, with significant cost reductions [ 21 , 22 ]. Rasburicase was also efficient in the prevention and management of TLS in resource-limited settings [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

“…A single low-dose of rasburicase has shown effectiveness in pediatric patients with NHL and AL in the management of TLS, with significant cost reductions [ 21 , 22 ]. Rasburicase was also efficient in the prevention and management of TLS in resource-limited settings [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Safety and Effectiveness of Rasburicase in the Control of Hyperuricemia in Pediatric Patients with Non-Hodgkin’s Lymphoma and Acute Leukemia: An Open-Label, Single-Arm, Multi-center, Interventional Study

et al. 2023

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Introduction Despite rasburicase's proven efficiency in Caucasians, Japanese, and Koreans, studies evaluating the safety and effectiveness of rasburicase in Chinese pediatric patients with non-Hodgkin’s lymphoma (NHL) and acute leukemia (AL) in particular are lacking. Objective The aim was to evaluate the safety and effectiveness of rasburicase in Chinese pediatric patients with NHL and AL. Methods In this phase IV, open-label, non-randomized, single-arm, multi-center, interventional study (NCT04349306), children newly diagnosed with NHL or AL who received 0.20 mg/kg/day of rasburicase were included. The primary objective was to assess the safety of rasburicase by the incidence of adverse events (AEs). The secondary objective was to determine the effectiveness of rasburicase in the control of hyperuricemia. Results Out of 50 patients, 25 reported a total of 76 treatment-emergent adverse events (TEAEs), including eight TEAEs of grade ≥ 3 in 12 patients. A drug-related serious AE was reported in one patient, and there was no incidence of death. The response rate in the intent-to-treat population was 100.0% (95% confidence interval 82.4–100.0) in patients ( n = 19) with baseline uric acid level of > 8.0 mg/dL. Similarly, the response rate was 86.2% ( n = 25) among 29 patients (60.4%) with baseline uric acid levels of ≤ 8.0 mg/dL. The maximum mean percentage decrease of plasma uric acid level in the overall patients was 96.9%. Conclusion Rasburicase was well tolerated and effective in controlling hyperuricemia in Chinese pediatric patients with NHL and AL. Supplementary Information The online version contains supplementary material available at 10.1007/s40268-023-00420-y.

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Principaux troubles hydro-électrolytiques chez le patient de cancérologie

et al. 2024

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Efficacy of Single Low-Dose Rasburicase in Management of Tumor Lysis Syndrome in Leukemia and Lymphoma Patients

Cited by 6 publications

References 16 publications

Acid freezes uricolysis in addition to glycolysis: Utility of fluoride-EDTA-citrate tube in the measurement of uric acid for patients administered rasburicase

Acid freezes uricolysis in addition to glycolysis: Utility of fluoride-EDTA-citrate tube in the measurement of uric acid for patients administered rasburicase

Safety and Effectiveness of Rasburicase in the Control of Hyperuricemia in Pediatric Patients with Non-Hodgkin’s Lymphoma and Acute Leukemia: An Open-Label, Single-Arm, Multi-center, Interventional Study

Principaux troubles hydro-électrolytiques chez le patient de cancérologie

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