성인 악성 종양 환자의 고뇨산혈증에 대한 Rasburicase 효능 분석 = Efficacy of Rasburicase on Hyperuricemia in Adult Patients with Malignant Tumor

다국어 초록 (Multilingual Abstract)

Rasburicase reduces uric acid levels by converting uric acid to allantoin. Allopurinol isthe most used in TLS(tumor lysis syndrome). However, it has limitations such as slow onset and kidneytoxicity. In Korea, a few research studies on rasburicase have been performed on pediatricpatients under 18 years. However, efficacy study of rasburicase in adult patients is limited. In thisstudy, we determined the efficacy of rasburicase on hyperuricemia in adult patients with malignanttumor and analyzed the factors that might have affected its ability to convert uric acid.
From November 2006 to July 2012, a retrospective study was designed to analyze laboratorychanges of patients administrated 0.2 mg/kg rasburicase in Seoul National University Hospital whohad malignant tumor over the age of 18. A total of 21 patients was included. This study observed uricacid, creatinine, blood urea nitrogen etc. until 96 hours after the first administration of rasburicase. After 12 hours, uric acid levels of all patients were significantly (p<0.05) decreased. Average uricacid levels were decreased from 10.69±4.07 mg/dL to 1.94±3.13 mg/dL and maintained until 96hours post the first administration of rasburicase. Regression analysis revealed that lower percentageof reduced degree of 96 hours-uric acid was associated with higher numbers of white blood cells(WBC) and higher plasma uric acid levels before administration.
In conclusion, rasburicase reduced uric acid levels in Korean adult patients effectively. Therefore, acareful monitoring will be required for patients who have high white blood cells or uric acid levelsbecause higher WBC and higher plasma uric acid levels before administration was associated withlower reduction of uric acid.

참고문헌 (Reference)

1 Health Insurance Review & Assessment Service,

2 Cairo M.S., "Tumour lysis syndrome: new therapeutic strategies and classification" 127 (127): 3-11, 2004

3 Ahn Y.H., "Tumor lysis syndrome in children: experience of last decade" 29 (29): 196-201, 2011

4 Howard S.C., "The tumor lysis syndrome" 364 (364): 1844-1854, 2011

5 Will A., "The clinical management of tumour lysis syndrome in haematological malignancies" 154 (154): 3-13, 2011

6 Trifilio S, "Reduceddose rasburicase(recombinant xanthine oxidase) in adult cancer patients with hyperuricemia" 37 (37): 997-1001, 2006

7 Cairo M.S, "Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome(TLS) in adults and children with malignant diseases: an expert TLS panel consensus" 149 (149): 578-586, 2010

8 Bosly A., "Rasburicase (recombinant urate oxidase) for the management of hyperuricemia in patients with cancer:report of an international compassionate use study" 98 (98): 1048-1054, 2003

9 Renyil I., "Prevention and treatment of hyperuricemia with rasburicase in children with leukemia and nonhodgkin’s lymphoma" 13 (13): 57-62, 2007

10 Pession A., "Pitfall, prevention, and treatment of hyperuricemia during tumor lysis syndrome in the era of rasburicase(recombinant urate oxidase)" 2 (2): 129-141, 2008

11 Coiffier B, "Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review" 26 (26): 2767-2778, 2008

12 Knoebel R.W, "Evaluation of a low, weight-based dose of rasburicase in adult patients for the treatment or prophylaxis of tumor lysis syndrome" 17 (17): 147-154, 2011

13 Trifilio S.M, "Effectiveness of a single 3mg rasburicase dose for the management of hyperuricemia in patients with hematological malignancies" 46 (46): 800-805, 2011

14 Goldman S.C., "A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis" 97 (97): 2998-3003, 2001