Coiffier Bertrand, Riouffol Catherine
Centre Hospital Lyon-Sud, Department of Hematology, 69310 Pierre-Benite, France.
Expert Rev Anticancer Ther. 2007 Feb;7(2):233-9. doi: 10.1586/14737140.7.2.233.
Spontaneous or treatment-induced tumor lysis syndrome (TLS) can cause significant morbidity and potential mortality. Vigorous hydration, alkalinization and inhibition of uric acid synthesis with allopurinol are the most frequently used methods for treatment and prevention of TLS. However, this approach fails to prevent renal insufficiency in up to 25% of high-risk patients. With the increased intensity and efficacy of cancer therapies, novel approaches for the management of TLS are needed. Unlike allopurinol, urate oxidase promptly reduces the existing uric acid pool, prevents accumulation of xanthine and hypoxanthine and does not require alkalinization, facilitating phosphorus excretion. A recombinant form of urate oxidase, rasburicase, is now registered for the treatment and prevention of TLS. This review provides an overview of rasburicase development and discusses the impact of rasburicase in the prevention and management of TLS.
自发性或治疗诱导的肿瘤溶解综合征（TLS）可导致严重的发病情况及潜在的死亡风险。积极补液、碱化尿液以及使用别嘌醇抑制尿酸合成是治疗和预防TLS最常用的方法。然而，这种方法在高达25%的高危患者中无法预防肾功能不全。随着癌症治疗强度和疗效的提高，需要新的TLS管理方法。与别嘌醇不同，尿酸氧化酶能迅速减少现有的尿酸池，防止黄嘌呤和次黄嘌呤的积累，且不需要碱化尿液，有利于磷的排泄。重组尿酸氧化酶制剂拉布立酶现已获批用于治疗和预防TLS。本综述概述了拉布立酶的研发情况，并讨论了拉布立酶在预防和管理TLS中的作用。
