Recombinant Urate Oxidase (Rasburicase) for the Prevention and Treatment of Tumor Lysis Syndrome in Patients with Hematologic Malignancies

Acta Haematologica - Tập 115 Số 1-2 - Trang 35-38 - 2006
Lin-Yen Wang1, Lee‐Yung Shih2, Hung Chang2, Shiann‐Tarng Jou3, Kai‐Hsin Lin3, Ting‐Chi Yeh1, Sheng-Fung Lin4, Der‐Cherng Liang1
1Divisions of Hematology-Oncology,Department of Pediatrics, Mackay Memorial Hospital,
2Department of Internal Medicine, Chang Gung Memorial Hospital, and
3Department of Pediatrics, National Taiwan University Hospital, Taipei
4Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Tóm tắt

In this multicenter, nonrandomized, open-label clinical trial conducted from July 2003 to July 2004, recombinant urate oxidase (rasburicase) was administered to patients at risk for tumor lysis syndrome before or during the initiation of chemotherapy. Forty-five patients were enrolled, including 18 children (10 with acute lymphoblastic leukemia, 6 with high-grade lymphoma, and 2 with acute myeloid leukemia) and 27 adults (8 with acute lymphoblastic leukemia, 4 with high-grade lymphoma, 9 with multiple myeloma, and 6 with acute myeloid leukemia). The age ranged from 3 to 98 years, with a median age of 7 years in children and 59.3 years in adults. There were 14 males and 4 females in the pediatric group and 18 males and 9 females in the adult group. Rasburicase 0.2 mg/kg was administered intravenously once a day for 2–6 days, for a median of 3 days in children and of 4 days in adults. After 3 days of treatment, the median uric acid levels in the 18 children decreased from 10.5 mg/dl (range 8–18.6) to 0.5 mg/dl (range 0.0–1.7). Similarly, in the 27 adults, the median levels decreased from 10.8 mg/dl (range 8–24.4) to 0.5 mg/dl (range 0.0–1.6). No significant changes were observed in serum potassium, calcium, and phosphorus concentrations. None of the patients required dialysis for acute renal failure. Rasburicase was very well tolerated, with only 1 adult having grade 1 vomiting. We conclude that rasburicase is safe and highly effective for preventing the complications of tumor lysis syndrome in patients with hematologic malignancies.

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Thông tin xuất bản

Acta Haematologica

Tập 115 Số 1-2

35-38

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