title: Management of tumor lysis syndrome with a single fixed dose of rasburicase in Asian lymphoma patients: a case series and literature review.
abstract: OBJECTIVE
  Recently, a number of studies have demonstrated the effectiveness of a single reduced dose of rasburicase for the management of tumor lysis syndrome (TLS) in adults. Whether Asian lymphoma patients similarly respond to a single dose of rasburicase is currently unknown. We aim to assess the efficacy of a single dose rasburicase in preventing TLS in Asian lymphoma patients.
  
  
  METHODS
  This was a single-center case series of adult lymphoma patients at high risk of TLS who received a single fixed dose of rasburicase. Patients had to have their uric acid, serum creatinine, lactate dehydrogenase and electrolytes monitored for at least 24-48 h post-administration.
  
  
  RESULTS
  Eleven patients were identified. Majority were Chinese (91%), male (64%) and with a median age of 61 years (range 41-84). All had at least two risk factors for developing TLS. Ten patients received a 6-mg dose and one received 4.5 mg. Prior to rasburicase administration, the mean uric acid level was 835 µmol/L (range 318-1237 µmol/L) and the level 24-h post-administration was 186 µmol/L (range 30-653 µmol/L) (P < 0.001). Eight patients (73%) experienced an improvement of renal function 72-h post-rasburicase. Normalization of serum electrolytes was achieved within 96 h.
  
  
  CONCLUSIONS
  Among Asian lymphoma patients who manifested at least two risk factors for developing TLS, a single fixed dose of rasburicase at 6 mg is deemed to be effective for rapidly lowering uric acid levels as well as sustaining reduced levels for up to 72 h.
authors.affiliation: Department of Pharmacy, National Cancer Centre Singapore, Singapore.
authors.forename: Joen
authors.initials: J
authors.lastname: Chiang
authors.forename: Alexandre
authors.initials: A
authors.lastname: Chan
authors.forename: Tracy
authors.initials: T
authors.lastname: Lian
authors.forename: Kevin
authors.initials: K
authors.lastname: Tay
authors.forename: Richard
authors.initials: R
authors.lastname: Quek
authors.forename: Miriam
authors.initials: M
authors.lastname: Tao
authors.forename: Soon Thye
authors.initials: ST
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D002051:Burkitt Lymphoma / Q000097:blood / Q000473:pathology*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015275:Tumor Lysis Syndrome / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D014503:Urate Oxidase / Q000627:therapeutic use*; D014527:Uric Acid / Q000097:blood
chemical_list: C469709:rasburicase; D014527:Uric Acid; D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D014503:Urate Oxidase