Review
Oncology
Michail Papapanou, Anastasios E. Athanasopoulos, Eleni Georgiadi, Stefanos A. Maragkos, Michalis Liontos, Dimitrios C. Ziogas, Dimitrios Damaskos, Dimitrios Schizas
Summary: A systematic review was conducted to recognize specific characteristics and parameters related to a worse prognosis in adult patients with solid tumors experiencing spontaneous tumor lysis syndrome (STLS). Metastatic disease, especially in the liver or lungs, was significantly associated with STLS-related death. The use of urate-lowering agents, specifically rasburicase monotherapy, was linked to a higher probability of death. Careful surveillance of high-risk cases is crucial for predicting morbidity and mortality.
Article
Urology & Nephrology
Tarek Barbar, Insara Jaffer Sathick
Summary: Tumor lysis syndrome is an oncologic emergency characterized by the release of large amounts of potassium, phosphate, and nucleic acids into the systemic circulation. Early recognition and treatment can prevent severe complications.
ADVANCES IN CHRONIC KIDNEY DISEASE
(2021)
Article
Medicine, General & Internal
Shoko Ito, Shin-ichiro Fujiwara, Tomoaki Yoshizawa, Kaori Hayatsu, Kaoru Sekiguchi, Rui Murahashi, Hirotomo Nakashima, Sae Matsuoka, Takashi Ikeda, Yumiko Toda, Shinichiro Kawaguchi, Takashi Nagayama, Kento Umino, Daisuke Minakata, Hirofumi Nakano, Kaoru Morita, Ryoko Yamasaki, Masahiro Ashizawa, Chihiro Yamamoto, Kaoru Hatano, Kazuya Sato, Ken Ohmine, Yoshinobu Kanda
Summary: Tumor lysis syndrome (TLS) is a metabolic disorder caused by massive tumor lysis. Hypouricemic agents are administered to prevent TLS-related hyperuricemia and renal failure. In some cases, these agents may lead to the formation of urine xanthine crystals, which should be carefully observed and managed during TLS to avoid xanthine nephropathy.
Article
Oncology
Dennis Marjoncu, Kori Holman
Summary: This study analyzed the efficacy and healthcare costs of using rasburicase at 3 mg and 6 mg doses to treat hyperuricemia. The results showed no difference in the uric acid normalization rate within 24 hours between the 3 mg and 6 mg dose groups. By using a 3 mg dose protocol, over $300,000 can be saved annually.
JOURNAL OF ONCOLOGY PHARMACY PRACTICE
(2023)
Article
Critical Care Medicine
Moustafa Abdel-Nabey, Anis Chaba, Justine Serre, Etienne Lengline, Elie Azoulay, Michael Darmon, Lara Zafrani
Summary: Acute kidney injury is common in tumor lysis syndrome patients. The use of rasburicase is associated with remission of the underlying malignancy. Delaying chemotherapy may have negative effects on long-term outcomes.
ANNALS OF INTENSIVE CARE
(2022)
Article
Pediatrics
Aditi Dey, Rita Wyrebek, Loraine Torres, Danilo Escoto, Fauzia Shakeel, Jennifer Mayer
Summary: This case describes a very preterm infant with a SCT who develops spontaneous preoperative tumor lysis syndrome (TLS) and underwent total gross resection at 40 h of life using rasburicase. The importance of early recognition and management of TLS, aggressive management of hyperkalemia, and consideration of early resection of SCTs even in very premature infants is emphasized.
Article
Oncology
Steven Gilmore, Melissa Carroll, Elizabeth Koselke, Shannon Hough
Summary: This study aimed to evaluate and optimize the dosing strategy for rasburicase in the management of tumor lysis syndrome-associated hyperuricemia within ambulatory community oncology practices. The revision of a network-wide guideline resulted in a reduction in average dose and cost of rasburicase without compromising clinical efficacy.
JOURNAL OF ONCOLOGY PHARMACY PRACTICE
(2023)
Article
Oncology
Heather P. May, Kristin C. Mara, Erin F. Barreto, Nelson Leung, Thomas M. Habermann
Summary: This study found a relationship between uric acid and eGFR changes in TLS patients, with an increase in uric acid area under the curve being positively correlated with a decrease in eGFR. Further research is needed to determine whether treatments that reduce uric acid exposure can improve kidney outcomes.
LEUKEMIA & LYMPHOMA
(2021)
Article
Oncology
Dennis Marjoncu, Kori Holman
Summary: The study aimed to evaluate the efficacy of different doses of rasburicase in the treatment of hyperuricemia and analyze its impact on healthcare costs. The results showed that a single 3 mg dose of rasburicase was as effective as a single 6 mg dose in normalizing uric acid levels, and using the lower dose was associated with significant cost-savings.
JOURNAL OF ONCOLOGY PHARMACY PRACTICE
(2023)
Review
Urology & Nephrology
Sheron Latcha, Chintan V. Shah
Summary: Tumor lysis syndrome (TLS) and high-dose methotrexate (HD MTX) toxicity can lead to severe complications, including acute kidney injury, in patients with malignancy. Guidelines for using rasburicase and glu-carpidase as rescue therapies for TLS and HD MTX toxicity are widely used to mitigate organ toxicity and decrease morbidity and mortality. This review discusses the pathogenesis of TLS and HD MTX-associated toxicity, the mechanism of action of these therapeutic agents, and the available evidence supporting their use.
SEMINARS IN NEPHROLOGY
(2022)
Article
Oncology
Swaratika Majumdar, Neha Sharma, Manju Sengar, Jayashree Thorat, Lingaraj Nayak, Avinash Bonda, Bhausaheb Bagal, Akhil Rajendra, Amit Sethi, Hasmukh Jain
Summary: The objective of this study was to investigate the plasma uric acid response rate. The use of low-dose rasburicase led to rapid and sustained reductions in uric acid levels in approximately 52% of patients.
LEUKEMIA & LYMPHOMA
(2023)
Article
Medicine, General & Internal
Marcus Lee, Michael Sandhu
Summary: Tumor lysis syndrome (TLS) is a life-threatening oncological emergency that occurs when electrolytes are released upon tumor cell death, leading to acute renal failure. While TLS is usually triggered by cytotoxic chemotherapy, it can rarely occur spontaneously. Our case report presents a patient with a known malignancy but not undergoing cytotoxic chemotherapy, who presented with metabolic derangements suggestive of spontaneous TLS. This case highlights the importance of considering TLS as a possible diagnosis even in the absence of cytotoxic chemotherapy.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2023)
Article
Oncology
Pankit Vachhani, Jeffrey Baron, Craig W. Freyer, Austin Miller, Meir Wetzler, James E. Thompson, Elizabeth A. Griffiths, Eunice S. Wang
Summary: The study aimed to determine the efficacy and safety of two single low doses of rasburicase in adult patients with acute leukemia. Results showed that this treatment regimen was highly effective in significantly reducing UA levels within 24 hours, with good tolerability and safety.
Article
Oncology
Shahrier Hossain, Martha Naber, Matthew J. Yacobucci
Summary: The study evaluated the effectiveness of low fixed-dose rasburicase as a treatment for tumor lysis syndrome, showing that a dose of 1.5 mg is sufficient for achieving target UA levels below 8 mg/dL for serum UA levels below 12 mg/dL, while a 3 mg dose is appropriate for levels above 12 mg/dL. Cost analysis indicated that this dosing strategy is more cost-efficient than the FDA-approved weight-based dose.
JOURNAL OF ONCOLOGY PHARMACY PRACTICE
(2022)
Article
Medicine, General & Internal
Deborah A. Aina, Ashley Erwin, Elton Li, Rajendra Manam
Summary: Spontaneous tumor lysis syndrome (STLS), a rare oncologic emergency, can lead to life-threatening renal failure and electrolyte imbalances. We present a case of STLS in a patient with newly diagnosed small-cell liver carcinoma (SCLC). Prompt diagnosis and treatment, including fluid rehydration and rasburicase administration, successfully improved renal function and normalized electrolytes and uric acid levels. Identifying SCLC as a risk factor for STLS is crucial for timely management of this rare condition.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2023)