Prevention and Treatment of Hyperuricemia with Rasburicase in Children with Leukemia and Non-Hodgkin’s Lymphoma

Imre RÉNYI1, Edit BÁRDI2, Erzsébet UDVARDI3, Gábor KOVÁCS4, Katalin BARTYIK5, Pál KAJTÁR6, Péter MASÁT7, Kálmán NAGY8, Ilona GALÁNTAI9, Csongor KISS2

11st Department of Pediatrics, Semmelweis University, Budapest, Hungary
2Department of Pediatrics, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
3Sanofi-Synthelabo Co., Budapest, Hungary
42nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
5Department of Pediatrics, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary
6Department of Pediatrics, Faculty of Medicine, University of Pécs, Pécs, Hungary
7Department of Pediatrics, Markusovszky Vas Country Hospital, Szombathely, Hungary
8Children’s Health Center, Borsod-Abaúj-Zemplén Country Hospital, Miskolc, Hungary
9Madarász Street Pediatric Hospital, Budapest, Hungary


To prevent acute renal failure in children at risk for developing tumor lysis syndrome due to acute lymphoblastic leukemia or non-Hodgkin’s lymphoma treated according to international BFM protocols, we investigated recombinant urate oxidase (rasburicase) in the first Central European openlabeled, prospective, multicenter phase IV trial. Rasburicase was administered intravenously, at 0.2 mg/kg for 5 consecutive days to 36 patients. Blood levels of uric acid, creatinine, phosphorus, calcium, lactate dehydrogenase and complete blood count were measured daily during rasburicase treatment and on days 6, 7 and 12. Initial uric acid level decreased significantly by 4 hours (from 343 micromol/L to 58 micromol/L, p<0.001), except for one steroid-resistant patient who required hemodialysis on day 14 after having introduced combined cytostatic treatment. Comparing the data of a subgroup of 12 patients receiving rasburicase with that of a historic cohort of 14 patients treated with allopurinol indicated the superiority of rasburicase over allopurinol in prophylaxis and treatment of hyperuricemia in children with leukemia and lymphoma. Pathology & Oncology Research, Vol 13, Nr 1, 57-62, 2007

Key words: rasburicase; uric acid; tumor lysis syndrome; leukemia; lymphoma

Received: Jun 19, 2006; accepted: Nov 20, 2006
Correspondence: Edit BÁRDI, Department of Pediatrics, Medical and Health Science Center, University of Debrecen, 98. Nagyerdei Circle Debrecen H-4012, Hungary; Tel: 36-52-414-992, Fax: 36-52-414-992; E-mail:

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