A randomized trial of a single-dose rasburicase versus five-daily doses in patients at risk for tumor lysis syndrome.

Tumor lysis syndrome (TLS) is a life-threatening disorder characterized by hyperuricemia and metabolic derangements. The efficacy of rasburicase, administered daily for 5 days, has been well established. However, the optimal duration of therapy is unknown in adults.
We evaluated the efficacy of rasburicase (0.15 mg/kg) administered as single dose followed by as needed dosing (maximum five doses) versus daily dosing for 5 days in adult patients at risk for TLS.
Eighty of the 82 patients enrolled received rasburicase; 40 high risk [median uric acid (UA) 8.5 mg/dl; range, 1.5-19.7] and 40 potential risk (UA = 5.6 mg/dl; range, 2.4-7.4). Seventy-nine patients (99%) experienced normalization in their UA within 4 h after the first dose; 84% to an undetectable level (<0.7 mg/dl). Thirty-nine of 40 (98%) patients in the daily-dose arm and 34 of 40 (85%) patients in single-dose arm showed sustained UA response. Six high-risk patients within the single-dose arm required second dose for UA >7.5 mg/dl. Rasburicase was well tolerated; one patient with glucose-6-phosphate dehydrogenase deficiency developed methemoglobinemia and hemolysis.
Rasburicase is highly effective for prevention and management of hyperuricemia in adults at risk for TLS. Single-dose rasburicase was effective in most patients; only a subset of high-risk patients required a second dose.
AuthorsS Vadhan-Raj, L E Fayad, M A Fanale, B Pro, A Rodriguez, F B Hagemeister, C E Bueso-Ramos, X Zhou, P W McLaughlin, N Fowler, J Shah, R Z Orlowski, F Samaniego, M Wang, J E Cortes, A Younes, L W Kwak, N J Sarlis, J E Romaguera
JournalAnnals of oncology : official journal of the European Society for Medical Oncology / ESMO (Ann Oncol) Vol. 23 Issue 6 Pg. 1640-5 (Jun 2012) ISSN: 1569-8041 [Electronic] England
PMID22015451 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antineoplastic Agents
  • Gout Suppressants
  • Uric Acid
  • Urate Oxidase
  • rasburicase
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents (adverse effects, therapeutic use)
  • Female
  • Gout Suppressants (administration & dosage, therapeutic use)
  • Humans
  • Lymphoma, Large B-Cell, Diffuse (drug therapy)
  • Male
  • Middle Aged
  • Risk Factors
  • Treatment Outcome
  • Tumor Lysis Syndrome (etiology, prevention & control)
  • Urate Oxidase (administration & dosage, therapeutic use)
  • Uric Acid (blood)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: