title: Recombinant urate oxidase (rasburicase) for the prevention and treatment of tumor lysis syndrome in patients with hematologic malignancies.
abstract: In this multicenter, nonrandomized, open-label clinical trial conducted from July 2003 to July 2004, recombinant urate oxidase (rasburicase) was administered to patients at risk for tumor lysis syndrome before or during the initiation of chemotherapy. Forty-five patients were enrolled, including 18 children (10 with acute lymphoblastic leukemia, 6 with high-grade lymphoma, and 2 with acute myeloid leukemia) and 27 adults (8 with acute lymphoblastic leukemia, 4 with high-grade lymphoma, 9 with multiple myeloma, and 6 with acute myeloid leukemia). The age ranged from 3 to 98 years, with a median age of 7 years in children and 59.3 years in adults. There were 14 males and 4 females in the pediatric group and 18 males and 9 females in the adult group. Rasburicase 0.2 mg/kg was administered intravenously once a day for 2-6 days, for a median of 3 days in children and of 4 days in adults. After 3 days of treatment, the median uric acid levels in the 18 children decreased from 10.5 mg/dl (range 8-18.6) to 0.5 mg/dl (range 0.0-1.7). Similarly, in the 27 adults, the median levels decreased from 10.8 mg/dl (range 8-24.4) to 0.5 mg/dl (range 0.0-1.6). No significant changes were observed in serum potassium, calcium, and phosphorus concentrations. None of the patients required dialysis for acute renal failure. Rasburicase was very well tolerated, with only 1 adult having grade 1 vomiting. We conclude that rasburicase is safe and highly effective for preventing the complications of tumor lysis syndrome in patients with hematologic malignancies.
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Lin-Yen
authors.initials: LY
authors.lastname: Wang
authors.forename: Lee-Yung
authors.initials: LY
authors.lastname: Shih
authors.forename: Hung
authors.initials: H
authors.lastname: Chang
authors.forename: Shiann-Tarng
authors.initials: ST
authors.lastname: Jou
authors.forename: Kai-Hsin
authors.initials: KH
authors.lastname: Lin
authors.forename: Ting-Chi
authors.initials: TC
authors.lastname: Yeh
authors.forename: Sheng-Fung
authors.initials: SF
authors.lastname: Lin
authors.forename: Der-Cherng
authors.initials: DC
authors.lastname: Liang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D019337:Hematologic Neoplasms / Q000097:blood / Q000150:complications; D006801:Humans; D007275:Injections, Intravenous; D007938:Leukemia / Q000097:blood / Q000150:complications; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000097:blood; D011188:Potassium / Q000097:blood; D012307:Risk Factors; D015275:Tumor Lysis Syndrome / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D014503:Urate Oxidase / Q000008:administration & dosage*; D014527:Uric Acid / Q000097:blood
chemical_list: C469709:rasburicase; D014527:Uric Acid; D010758:Phosphorus; D014503:Urate Oxidase; D011188:Potassium; D002118:Calcium