Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Clin Lymphoma Myeloma Leuk. 2022 Feb;22(2):e71-e76. doi: 10.1016/j.clml.2021.08.009. Epub 2021 Aug 28.
Tumor lysis syndrome (TLS) is a commonly observed oncological emergency that requires prompt diagnosis and treatment. Rasburicase is a recombinant urate oxidase endorsed in TLS for the treatment of hyperuricemia. The effect of single-dose 7.5 mg rasburicase at longer follow-ups was not widely investigated.
Eighty-two patients included in the study with clinical TLS and laboratory TLS. The primary endpoint was the normalization of uric acid (<6mg/dL) within 24 hours of rasburicase administration, which was described as treatment success. The secondary endpoint was defined as having sustained response at the first week. The third endpoint was defined as the reaching the baseline renal function before TLS.
We found that the use of a 7.5 mg dose of rasburicase controlled uric acid in 74 of 82 (90,2%) patients at the 24th hour. In the first week, uric acid remained at normal levels in 69 of 82 (84,1%) patients. At 24 hours, the TLS risk group was the only predictor for failing uric acid normalization; at the end of the first week, no predictive factor was identified for failing uric acid normalization.
Rasburicase at 7.5 mg dose is an important agent for controlling laboratory and clinical TLS at 24 hours and extending its effect to the first week.
肿瘤溶解综合征（TLS）是一种常见的肿瘤急症，需要及时诊断和治疗。拉布立酶是一种重组尿酸氧化酶，被批准用于 TLS 以治疗高尿酸血症。单次 7.5mg 拉布立酶的疗效在更长时间的随访中尚未得到广泛研究。
本研究纳入了 82 例具有临床 TLS 和实验室 TLS 的患者。主要终点是拉布立酶给药后 24 小时内尿酸（<6mg/dL）正常化，将其描述为治疗成功。次要终点定义为第 1 周时持续应答。第三个终点定义为 TLS 前恢复至基线肾功能。
我们发现，7.5mg 拉布立酶剂量可在 24 小时内控制 82 例患者中的 74 例（90.2%）的尿酸。在第 1 周时，82 例患者中有 69 例（84.1%）尿酸仍处于正常水平。在 24 小时时，TLS 风险组是尿酸正常化失败的唯一预测因素；在第 1 周结束时，没有发现尿酸正常化失败的预测因素。
7.5mg 剂量的拉布立酶是控制实验室和临床 TLS 24 小时并将其疗效延长至第 1 周的重要药物。
