Prevention and treatment of hyperuricemia with rasburicase in children with leukemia and non-Hodgkin’s lymphoma

Rényi, Imre; Bárdi, Edit; Udvardi, Erzsébet; Kovàcs, Gabór; Bartyik, Katalin; Kajtár, P.; Masát, Péter; Nagy, Kaiman; Galántai, Ilona; Kiss, Csongor

doi:10.1007/bf02893442

Cited by 25 publications

(25 citation statements)

References 11 publications

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“…The study reported that the duration of rasburicase treatment should be tailored to the duration and intensity of tumor cell lysis in the patient by closely monitoring clinical chemistry. The superiority of rasburicase in comparison with allopurinol for the prophylaxis and treatment of hyperuricemia in children with leukemia and lymphoma has been demonstrated [24]. Rasburicase, administered at a dose of 0.20 mg/kg for 5 consecutive days, resulted in a rapid and significant decrease in uric acid levels after 4 h [24], in line with the findings reported in the current study.…”

Section: Discussionsupporting

confidence: 91%

“…The superiority of rasburicase in comparison with allopurinol for the prophylaxis and treatment of hyperuricemia in children with leukemia and lymphoma has been demonstrated [24]. Rasburicase, administered at a dose of 0.20 mg/kg for 5 consecutive days, resulted in a rapid and significant decrease in uric acid levels after 4 h [24], in line with the findings reported in the current study. Rasburicase was also a more potent and more rapid uricolytic agent than allopurinol.…”

Section: Discussionsupporting

confidence: 91%

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A study of rasburicase for the management of hyperuricemia in pediatric patients with newly diagnosed hematologic malignancies at high risk for tumor lysis syndrome

et al. 2009

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Tumor lysis syndrome (TLS), including hyperuricemia, is a frequent serious complication in patients with hematologic malignancies. This study in Japanese patients evaluated the efficacy, safety, and pharmacokinetic profile of rasburicase in pediatric patients with hematologic malignancies. Patients aged <18 years at high risk for TLS, with newly diagnosed hematologic malignancies, were randomized to intravenous rasburicase 0.15 mg/kg/day (n = 15) or 0.20 mg/kg/day (n = 15) for 5 days. Chemotherapy was started 4-24 h after the first rasburicase dose. Response was defined as a reduction in plasma uric acid to < or = 6.5 mg/dL (patients <13 years) or < or = 7.5 mg/dL (patients > or = 13 years) by 48 h after the first administration, lasting until 24 h after the final administration. Response rates were 93.3 and 100% with rasburicase 0.15 and 0.20 mg/kg/day, respectively. Uric acid levels declined rapidly within 4 h of starting rasburicase administration in both groups. Most adverse events were related to the underlying chemotherapy regimens. Two hypersensitivity reactions, including grade 1/2 pruritus, were considered to be related to rasburicase. Rasburicase is effective and well tolerated for the management of hyperuricemia in Japanese pediatric patients at high risk of developing TLS.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

A study of rasburicase for the management of hyperuricemia in pediatric patients with newly diagnosed hematologic malignancies at high risk for tumor lysis syndrome

et al. 2009

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“…4 Recombinant urate oxidase (rasburicase) has been found to be useful in managing hyperuricemia. [5][6][7][8] The recommended pediatric dose of rasburicase (0.15-0.20 mg/kg for 3-7 days) is very effective for adults as well. Indeed, it usually lowers the serum uric acid concentration to levels much below the normal range.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a single 3-mg rasburicase dose for the management of hyperuricemia in patients with hematological malignancies

Trifilio

Zook

et al. 2010

Bone Marrow Transplant

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Rasburicase was administered at a fixed dose of 3 mg to treat 287 episodes of elevated serum uric acid levels (>7 mg/dL) in 247 adult patients with hematological malignancies. The median total dose of 36 μg/kg (range: 18-65) was a fraction of the recommended total pediatric dose of 0.75-1.0 mg/kg. The median change in uric acid levels at 24 h was -4.1 mg/dL (range: -12 to +1) and -45% (range: -95 to +9). Uric acid levels normalized at 24 h in 72% of patients. There was no relationship between the weight-based dose and uric acid decline. The only predictor of success was the baseline uric acid; the failure rate was 84% with baseline level >12 mg/dL and 18% if it was ≤ 12. Uric acid levels continued to decline beyond 24 h in most patients without additional treatment. Serum creatinine remained stable over 24 h, and declined over 48 h and 7 days. There was no relationship between the extent of reduction in uric acid levels and serum creatinine. We conclude that a single 3-mg dose of rasburicase, used with close monitoring, is sufficient to treat most adults with uric acid levels up to 12 mg/dL.

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“…Prophylactic treatment of TLS is aggressive hydration and allopurinol before cytotoxic therapy. The efficacy of rasburicase is considered superior to that of allopurinol even for prophylaxis [5]. Sunitinib is an oral antityrosine kinase inhibitor that has antiangiogenic and antitumor activities.…”

Section: Discussionmentioning

confidence: 99%

Sunitinib inducing tumor lysis syndrome in a patient treated for renal carcinoma

et al. 2009

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Prevention and treatment of hyperuricemia with rasburicase in children with leukemia and non-Hodgkin’s lymphoma

Cited by 25 publications

References 11 publications

A study of rasburicase for the management of hyperuricemia in pediatric patients with newly diagnosed hematologic malignancies at high risk for tumor lysis syndrome

A study of rasburicase for the management of hyperuricemia in pediatric patients with newly diagnosed hematologic malignancies at high risk for tumor lysis syndrome

Effectiveness of a single 3-mg rasburicase dose for the management of hyperuricemia in patients with hematological malignancies

Sunitinib inducing tumor lysis syndrome in a patient treated for renal carcinoma

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