title: Low-dose rasburicase in hematologic malignancies.
abstract: OBJECTIVE
  To define the efficacy and safety of low-dose rasburicase in children from south India with hematologic malignancies.
  
  
  METHODS
  This study is a retrospective analysis of data on 41 children with hematologic malignacies with laboratory evidence of tumor lysis syndrome (TLS) or clinical features indicating high risk for developing TLS. Patients were treated with rasburicase in doses of 0.1-0.15 mg/kg dose, repeated when necessary.
  
  
  RESULTS
  Male : Female ratio was 32:9. Thirty-six children had laboratory evidence of TLS and 5 were at risk for TLS. Diagnoses were T-cell acute lymphoblastic leukemia (ALL), 19; Pre-B ALL, 17; B-non-Hodgkin lymphoma (NHL), 2; T-NHL, 2; and acute myeloid leukemia (AML), 1. Initial plasma uric acid (PUA): median, 8.5 mg/dl (range, 4.3 to 45.5). Six had creatinine levels of >2 mg/dl on admission; and 10 had peak PO4 levels of >10 mg/dl. Dose of rasburicase used: median, 0.12 mg/kg (range, 0.08-0.24). Median reduction of PUA at 6 h: 80 % (range 40 to 98 %). Twenty-seven needed only one dose; 12 needed 2 or 3 doses; and two needed 5 doses each. One child required dialysis. None of the children developed anaphylaxis or hemolysis and there were no deaths from TLS.
  
  
  CONCLUSIONS
  Low-dose rasburicase (0.1-0.15 mg/kg) is safe and effective in reducing PUA in Indian children with lymphoid malignancies, and thus it may reduce the risk of renal failure from TLS.
authors.affiliation: Division of Pediatric Hematology-Oncology, Meenakshi Mission Hospital & Research Centre, Lake Area, Melur Road, Madurai, Tamil Nadu, India, sjayabose@gmail.com.
authors.forename: Somasundaram
authors.initials: S
authors.lastname: Jayabose
authors.forename: Vignesh
authors.initials: V
authors.lastname: Kumar
authors.forename: Rajeswari
authors.initials: R
authors.lastname: Dhanabalan
authors.forename: Priya
authors.initials: P
authors.lastname: Rajan
authors.forename: Krishnakumar
authors.initials: K
authors.lastname: Rathnam
authors.forename: T Kasi
authors.initials: TK
authors.lastname: Viswanathan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006074:Gout Suppressants / Q000008:administration & dosage* / Q000009:adverse effects; D019337:Hematologic Neoplasms / Q000188:drug therapy*; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D015275:Tumor Lysis Syndrome / Q000188:drug therapy*; D014503:Urate Oxidase / Q000008:administration & dosage* / Q000009:adverse effects; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
chemical_list: D006074:Gout Suppressants; C469709:rasburicase; D014527:Uric Acid; D014503:Urate Oxidase