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

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Pathology & Oncology Research

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 μmol/L to 58 μmol/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.

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Abbreviations

TLS:

tumor lysis syndrome

HPOG:

Hungarian Pediatric Oncology Group

BFM:

Berlin-Frankfurt-Münster

ALL:

acute lymphoblastic leukemia

NHL:

non-Hodgkin’s lymphoma

MHSCUD:

Medical and Health Science Center, University of Debrecen

LDH:

lactate dehydrogenase

BCP:

B-cell progenitor

CBC:

complete blood count

WBC:

white blood cell count

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Authors and Affiliations

  1. 1st Department of Pediatrics, Semmelweis University, Budapest

    Imre Rényi

  2. Department of Pediatrics, Medical and Health Science Center, University of Debrecen, 98. Nagyerdei Circle, P.O. Box 32, H-4012, Debrecen, Hungary

    Edit Bárdi & Csongor Kiss

  3. Sanofi-Synthelabo Co., Budapest

    Erzsébet Udvardi

  4. 2nd Department of Pediatrics, Semmelweis University, Budapest

    Gábor Kovács

  5. Department of Pediatrics, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged

    Katalin Bartyik

  6. Department of Pediatrics, Faculty of Medicine, University of Pécs, Pécs

    Pal Kajtár

  7. Department of Pediatrics, Markusovszky Vas Country Hospital, Szombathely

    Péter Masát

  8. Children’s Health Center of Borsod-Abaúj-Zemplén Country Hospital, Miskolc

    Kaiman Nagy

  9. Madarász Street pediatric Hospital, Budapest, Hungary

    Ilona Galántai

Authors
  1. Imre Rényi
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  2. Edit Bárdi
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  3. Erzsébet Udvardi
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  4. Gábor Kovács
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  5. Katalin Bartyik
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  6. Pal Kajtár
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  7. Péter Masát
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  8. Kaiman Nagy
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  9. Ilona Galántai
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  10. Csongor Kiss
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Corresponding author

Correspondence to Edit Bárdi.

Additional information

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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Rényi, I., Bárdi, E., Udvardi, E. et al. Prevention and treatment of hyperuricemia with rasburicase in children with leukemia and non-Hodgkin’s lymphoma. Pathol. Oncol. Res. 13, 57–62 (2007). https://doi.org/10.1007/BF02893442

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  • DOI: https://doi.org/10.1007/BF02893442

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