Reduced-dose rasburicase (recombinant xanthine oxidase) in adult cancer patients with hyperuricemia (original) (raw)
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- Published: 17 May 2006
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Abstract
Recombinant urate oxidase (rasburicase) lowers uric acid levels rapidly to very low levels at the labeled dose of 0.15–0.2 mg/kg daily for 5 days. Our past experience showed that a lower dose (3 mg) lowered uric acid levels sufficiently in most patients. A retrospective review was conducted to determine the effect of a fixed 3 mg dose of rasburicase in 43 adult patients with cancer undergoing hematopoietic stem cell transplantation or receiving chemotherapy who had elevated or rising uric acid levels (6.4–16.8 mg/dl; median 9.6). Six patients received a second dose of rasburicase (3 mg in four patients and 1.5 mg in two patients) 24 h later. Patients received allopurinol, adequate hydration, as well as other supportive therapy as required. Uric acid levels declined by 6–95% (median 43%) within the first 24 h after rasburicase administration, and levels at 48 h were 9–91% (median 65%) lower than the baseline levels. Serum creatinine changed by ⩽10% in 21 patients, increased by >10% in four patients and decreased by >10% in 18 patients. No significant renal dysfunction developed in any of the patients. We conclude that rasburicase is effective in lowering uric acid levels at a fixed dose of 3 mg, which is much lower than the recommended dose.
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Authors and Affiliations
- Pharmacy Department, Northwestern Memorial Hospital, Chicago, IL, USA
S Trifilio & J Pi - Division of Hematology/Oncology, Hematopoietic Stem Cell Transplant Program, The Feinberg School of Medicine, The Robert H Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
S Trifilio, L Gordon, S Singhal, M Tallman, A Evens, K Rashid, M Fishman, K Masino & J Mehta
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- S Trifilio
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Correspondence toJ Mehta.
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Trifilio, S., Gordon, L., Singhal, S. et al. Reduced-dose rasburicase (recombinant xanthine oxidase) in adult cancer patients with hyperuricemia.Bone Marrow Transplant 37, 997–1001 (2006). https://doi.org/10.1038/sj.bmt.1705379
- Received: 02 November 2005
- Revised: 20 March 2006
- Accepted: 25 March 2006
- Published: 17 May 2006
- Issue Date: 01 June 2006
- DOI: https://doi.org/10.1038/sj.bmt.1705379