Abstract | BACKGROUND: PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSIONS:
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.
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Authors | S 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 |
Journal | Annals of oncology : official journal of the European Society for Medical Oncology
(Ann Oncol)
Vol. 23
Issue 6
Pg. 1640-5
(Jun 2012)
ISSN: 1569-8041 [Electronic] England |
PMID | 22015451
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antineoplastic Agents
- Gout Suppressants
- rasburicase
- Uric Acid
- Urate Oxidase
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Topics |
- 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)
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