title: Prevention and treatment of hyperuricemia with rasburicase in children with leukemia and non-Hodgkin's lymphoma.
abstract: To prevent acute renal failure in children at risk for developing tumor lysis syndrome due to acute lymphoblastic leukemia or non-Hodgkin's lymphoma treated according to international BFM protocols, we investigated recombinant urate oxidase (rasburicase) in the first Central European openlabeled, prospective, multicenter phase IV trial. Rasburicase was administered intravenously, at 0.2 mg/kg for 5 consecutive days to 36 patients. Blood levels of uric acid, creatinine, phosphorus, calcium, lactate dehydrogenase and complete blood count were measured daily during rasburicase treatment and on days 6, 7 and 12. Initial uric acid level decreased significantly by 4 hours (from 343 micromol/L to 58 micromol/L, p<0.001), except for one steroid-resistant patient who required hemodialysis on day 14 after having introduced combined cytostatic treatment. Comparing the data of a subgroup of 12 patients receiving rasburicase with that of a historic cohort of 14 patients treated with allopurinol indicated the superiority of rasburicase over allopurinol in prophylaxis and treatment of hyperuricemia in children with leukemia and lymphoma.
authors: 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors: Imre
authors: I
authors: Rényi
authors: Edit
authors: E
authors: Bárdi
authors: Erzsébet
authors: E
authors: Udvardi
authors: Gábor
authors: G
authors: Kovács
authors: Katalin
authors: K
authors: Bartyik
authors: Pál
authors: P
authors: Kajtár
authors: Péter
authors: P
authors: Masát
authors: Kálmán
authors: K
authors: Nagy
authors: Ilona
authors: I
authors: Galántai
authors: Csongor
authors: C
authors: Kiss
mesh_terms: D000293:Adolescent; D000493:Allopurinol / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000188:drug therapy* / Q000517:prevention & control*; D007223:Infant; D007938:Leukemia / Q000097:blood / Q000150:complications*; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000150:complications*; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014503:Urate Oxidase / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014527:Uric Acid / Q000097:blood
chemical_list: D011994:Recombinant Proteins; C469709:rasburicase; D014527:Uric Acid; D000493:Allopurinol; D014503:Urate Oxidase