title: Effectiveness of a single 3-mg rasburicase dose for the management of hyperuricemia in patients with hematological malignancies.
abstract: 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.
authors.affiliation: Northwestern Memorial Hospital, and The Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Trifilio
authors.forename: J
authors.initials: J
authors.lastname: Pi
authors.forename: J
authors.initials: J
authors.lastname: Zook
authors.forename: M
authors.initials: M
authors.lastname: Golf
authors.forename: K
authors.initials: K
authors.lastname: Coyle
authors.forename: D
authors.initials: D
authors.lastname: Greenberg
authors.forename: D
authors.initials: D
authors.lastname: Newman
authors.forename: M
authors.initials: M
authors.lastname: Koslosky
authors.forename: J
authors.initials: J
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006074:Gout Suppressants; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D033461:Hyperuricemia / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014503:Urate Oxidase / Q000008:administration & dosage*; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
chemical_list: D006074:Gout Suppressants; C469709:rasburicase; D014527:Uric Acid; D014503:Urate Oxidase