Management of tumor lysis syndrome with a single fixed dose of rasburicase in Asian lymphoma patients: a case series and literature review.

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.
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.
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.
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.
AuthorsJoen Chiang, Alexandre Chan, Tracy Lian, Kevin Tay, Richard Quek, Miriam Tao, Soon Thye Lim
JournalAsia-Pacific journal of clinical oncology (Asia Pac J Clin Oncol) Vol. 7 Issue 4 Pg. 351-6 (Dec 2011) ISSN: 1743-7563 [Electronic] Australia
PMID22151984 (Publication Type: Journal Article, Review)
Copyright© 2011 Blackwell Publishing Asia Pty Ltd.
Chemical References
  • rasburicase
  • Uric Acid
  • Creatinine
  • L-Lactate Dehydrogenase
  • Urate Oxidase
  • Adult
  • Aged
  • Aged, 80 and over
  • Asia
  • Burkitt Lymphoma (blood, pathology)
  • Creatinine (blood)
  • Female
  • Humans
  • L-Lactate Dehydrogenase (blood)
  • Lymphoma, Large B-Cell, Diffuse (blood, pathology)
  • Male
  • Middle Aged
  • Risk Factors
  • Tumor Lysis Syndrome (blood, drug therapy, pathology)
  • Urate Oxidase (therapeutic use)
  • Uric Acid (blood)

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