Guidelines for Complications of Cancer Treatment Vol VIII Part B

4. Efficacy and safety of rasburicase, a recombinanturate oxidase (Elitek), in the management ofmalignancy-associated hyperuricemia inpediatric and adult patients: final results of amulticenter compassionate use trial.Jeha S, Kantarjian H, Irwin D, et al. Leukemia.2005;19:34-8.The recombinant urate oxidase, rasburicase (Elitek, Sanofi-Synthelabo, Inc.), has recently received regulatory approvalfor the prevention and treatment of hyperuricemia in childrenwith leukemia, lymphoma, and solid tumors. Prior to approval,682 children and 387 adults in the US and Canada receivedrasburicase on compassionate-use basis. Uric acidconcentration declined rapidly in both adult and pediatricpatients after rasburicase treatment. Similar responses wereobserved in patients treated with subsequent courses. Possibledrug-related adverse events, including allergic reactions, wereuncommon. These data confirm that rasburicase is effectiveand safe for the treatment and prophylaxis of children andadults with malignancy-associated hyperuricemia.5. Reduced-dose rasburicase (recombinantxanthine oxidase) in adult cancer patients withhyperuricemia.Trifilio S, Gordon L, Singhal S, et al Bone MarrowTransplant. 2006;37:997-1001.Recombinant urate oxidase (rasburicase) lowers uric acidlevels 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 alower dose (3 mg) lowered uric acid levels sufficiently in mostpatients. A retrospective review was conducted to determinethe effect of a fixed 3 mg dose of rasburicase in 43 adult patientswith cancer undergoing hematopoietic stem cell transplantationor receiving chemotherapy who had elevated or rising uric439