title: Single dose rasburicase in the management of tumor lysis syndrome in childhood acute lymphoblastic leukemia: A case series.
abstract: Tumor lysis syndrome (TLS) occurs in malignancies with high proliferative potential and tumor burden, such as lymphomas and leukemias. TLS syndrome is an oncologic emergency, requiring prompt intervention. The metabolic derangements cause acute kidney failure and may lead to cardiac arrhythmias, seizures, and death. With the advent of rasburicase, a recombinant urate oxidase, there has been a decline in the TLS-mediated renal failure and the need for dialysis. The recommended regimen and doses pose a heavy financial burden for patients in developing countries like India. With data and studies proving a similar efficacy for the reduced dose and lesser number of rasburicase, we report here a case series of seven children with acute leukemias, whose TLS was managed by a single dose of rasburicase. A retrospective analysis of case records of seven children with acute lymphoblastic leukemia and TLS, admitted to our Pediatric Oncology Unit of our Hospital between the period 2011 and 2013, was done. All our patients responded to a single dose, indicating that in appropriately monitored patients, single dose followed by as-needed dosing can be cost-saving.
authors.affiliation: Department of Paediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra Medical Centre, Pour, Chennai, Tamil Nadu, India.
authors.forename: S M
authors.initials: SM
authors.lastname: Latha
authors.affiliation: Department of Paediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra Medical Centre, Pour, Chennai, Tamil Nadu, India.
authors.forename: D
authors.initials: D
authors.lastname: Krishnaprasadh
authors.affiliation: Department of Paediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra Medical Centre, Pour, Chennai, Tamil Nadu, India.
authors.forename: P
authors.initials: P
authors.lastname: Murugapriya
authors.affiliation: Department of Paediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra Medical Centre, Pour, Chennai, Tamil Nadu, India.
authors.forename: J X
authors.initials: JX
authors.lastname: Scott
keywords: Single dose rasburicase; children; tumor lysis syndrome management
references.citation: J Clin Oncol. 2008 Jun 1;26(16):2767-78
references.pmid: 18509186
references.citation: Cancer Treat Rev. 2010 Apr;36(2):164-76
references.pmid: 20031331
references.citation: Eur J Haematol. 2008 Apr;80(4):331-6
references.pmid: 18081720
references.citation: Semin Nephrol. 1993 May;13(3):273-80
references.pmid: 8321927
references.citation: Leukemia. 2001 Oct;15(10):1505-9
references.pmid: 11587206
references.citation: J Biol Chem. 1992 Apr 25;267(12):8565-70
references.pmid: 1339455
references.citation: Leukemia. 2005 Jan;19(1):34-8
references.pmid: 15510203
references.citation: Am J Med. 1993 Feb;94(2):133-9
references.pmid: 8430709
references.citation: Leukemia. 1997 Nov;11(11):1813-6
references.pmid: 9369411
references.citation: Blood. 2001 May 15;97(10):2998-3003
references.pmid: 11342423
references.citation: Ann Pharmacother. 2003 Nov;37(11):1614-7
references.pmid: 14565793
references.citation: J Clin Oncol. 2000 Apr;18(8):1758-63
references.pmid: 10764437
references.citation: Pharmacotherapy. 2006 Jun;26(6):806-12
references.pmid: 16716134
references.citation: Ann Oncol. 2012 Jun;23(6):1640-5
references.pmid: 22015451
references.citation: J Clin Pharm Ther. 2013 Aug;38(4):301-8
references.pmid: 23550846
references.citation: Nephrol Dial Transplant. 2009 Oct;24(10):2960-4
references.pmid: 19581334