Effectiveness of a single 3-mg rasburicase dose for the management of hyperuricemia in patients with hematological malignancies

S. M. Trifilio, J. Pi, J. Zook, M. Golf, K. Coyle, D. Greenberg, D. Newman, M. Koslosky, J. Mehta*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Rasburicase was administered at a fixed dose of 3 mg to treat 287 episodes of elevated serum uric acid levels (>7 mg/dL) in 247 adult patients with hematological malignancies. The median total dose of 36 μg/kg (range: 18-65) was a fraction of the recommended total pediatric dose of 0.75-1.0 mg/kg. The median change in uric acid levels at 24 h was -4.1 mg/dL (range: -12 to +1) and -45% (range: -95 to +9). Uric acid levels normalized at 24 h in 72% of patients. There was no relationship between the weight-based dose and uric acid decline. The only predictor of success was the baseline uric acid; the failure rate was 84% with baseline level >12 mg/dL and 18% if it was ≤12. Uric acid levels continued to decline beyond 24 h in most patients without additional treatment. Serum creatinine remained stable over 24 h, and declined over 48 h and 7 days. There was no relationship between the extent of reduction in uric acid levels and serum creatinine. We conclude that a single 3-mg dose of rasburicase, used with close monitoring, is sufficient to treat most adults with uric acid levels up to 12 mg/dL.

Original languageEnglish (US)
Pages (from-to)800-805
Number of pages6
JournalBone Marrow Transplantation
Volume46
Issue number6
DOIs
StatePublished - Jun 2011

Keywords

  • hematological malignancy
  • hyperuricemia
  • rasburicase

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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