Prevention and treatment of hyperuricemia with rasburicase in children with leukemia and non-Hodgkin’s lymphoma

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Prevention and treatment of hyperuricemia with rasburicase in children with leukemia and non-Hodgkin’s lymphoma
Springer

Journal: Pathology & Oncology Research
Publisher: Springer Netherlands
ISSN: 1219-4956 (Print) 1532-2807 (Online)
Issue: Volume 13, Number 1 / March, 2007
Category: Article
DOI: 10.1007/BF02893442
Pages: 57-62
Subject Collection: Biomedical and Life Sciences
SpringerLink Date: Tuesday, April 29, 2008

Imre Rényi1, Edit Bárdi2 Contact Information, Erzsébet Udvardi3, Gábor Kovács4, Katalin Bartyik5, Pal Kajtár6, Péter Masát7, Kaiman Nagy8, Ilona Galántai9 and Csongor Kiss2
(1) 1st Department of Pediatrics, Semmelweis University, Budapest
(2) Department of Pediatrics, Medical and Health Science Center, University of Debrecen, 98. Nagyerdei Circle, P.O. Box 32, H-4012 Debrecen, Hungary
(3) Sanofi-Synthelabo Co., Budapest
(4) 2nd Department of Pediatrics, Semmelweis University, Budapest
(5) Department of Pediatrics, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged
(6) Department of Pediatrics, Faculty of Medicine, University of Pécs, Pécs
(7) Department of Pediatrics, Markusovszky Vas Country Hospital, Szombathely
(8) Children’s Health Center of Borsod-Abaúj-Zemplén Country Hospital, Miskolc
(9) Madarász Street pediatric Hospital, Budapest, Hungary

Received: 19 June 2006 Accepted: 20 November 2006
Abstract To prevent acute renal failure in children at risk for developing tumor lysis syndrome due to acute lymphoblastic leukemia or non-Hodgkin’s lymphoma treated according to international BFM protocols, we investigated recombinant urate oxidase (rasburicase) in the first Central European openlabeled, prospective, multicenter phase IV trial. Rasburicase was administered intravenously, at 0.2 mg/kg for 5 consecutive days to 36 patients. Blood levels of uric acid, creatinine, phosphorus, calcium, lactate dehydrogenase and complete blood count were measured daily during rasburicase treatment and on days 6, 7 and 12. Initial uric acid level decreased significantly by 4 hours (from 343 &#956;mol/L to 58 &#956;mol/L, p<0.001), except for one steroid-resistant patient who required hemodialysis on day 14 after having introduced combined cytostatic treatment. Comparing the data of a subgroup of 12 patients receiving rasburicase with that of a historic cohort of 14 patients treated with allopurinol indicated the superiority of rasburicase over allopurinol in prophylaxis and treatment of hyperuricemia in children with leukemia and lymphoma.

Both authors contributed equally to this work.
The study of the investigational new drug was approved and it was provided by Sanofi-Synthelabo Inc., Budapest, Hungary. This work was supported by the grant of the Health Science Council of the Ministry of Health, Republic of Hungary (ETT) No. 225.

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