دوشنبه 1 آبان 1396
به پورتال جامع کنگره ها - سمینارها و همایشهای دانشگاه علوم پزشکی تبریز خوش آمدید
   October 23, 2017
   
   
     
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Title Efficacy of low dose of Rasburicase for the prevention of Tumor lysis syndrome in children
Authors Amirataollah Hiradfar Maryam Banihosseinian
Abstract Tumor lysis syndrome (TLS) is an oncologic emergency that is caused by massive tumor cell lysis after initiation of cytotoxic therapy particularly in patients with acute lymphoblastic leukemia (ALL) and Burkitt type lymphoma. Catabolism of the nucleic acid to uric acid leads to hyperuricemia. High concentration of both uric acid and phosphate potentiate the risk of acute renal injury. The major causes of death in patients with clinical TLS are hemorrhage and renal failure. Now a day, therapy with urate oxidase (Rasburicase) is the main aim of new strategies to prevention of overt clinical TLS in high risk patients. Many recent published clinical trials emphases that Rasburicase can prevent of TLS by fast reduction in serum uric acid in high risk children than Alluporinol. According to three validate clinical trial in children with high risk lymphoma and leukemia; No patients with a pretreatment hyperuricemia (≥ 8 mg/dl) on prophylactic with rasburicase (0.2 mg/kg intravenous daily for 5 to 7 days) required dialysis, and there were no adverse events with rasburiacase. Since September 2012 to July 2016 In Tabriz Children Hospital; there were 23 patients with hematopoietic malignancy with clinical TLS before treatment of chemotherapy. The patients were randomly assigned in two groups with conventional dose/time and low dose/time (0.1 mg/kg intravenous daily for 2 days) Rasburicase prophylactic therapy. Reduction of serum phosphate, creatinine, and uric acid con centrations after 48 hours of therapy were same in two groups. There was no any rebound hyperuricemia in low dose rasburicase group in our study. No patients in both groups required dialysis. Rasburicase is an effective and safe prophylactic therapy in clinical TLS. Rasburicase is an expensive and rare therapy in our country; we recommended low dose of rasburicase with shorter time also effective in prevention of renal injury in high risk children.
Keywords tumor lysis, rasburisae, leukemia, lymphoma
 
     
     
 
 
     
     
 
 
     
     
 

برنامه اتوماسیون اداری
 
     
     
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