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Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase

Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs in oncologic and hematologic patients with large tumor burden, either due to cytotoxic therapy or, less commonly, spontaneously because of massive tumor cell lysis. TLS is clinically characterized by acute renal failu...

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Autores principales: Alakel, Nael, Middeke, Jan Moritz, Schetelig, Johannes, Bornhäuser, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295804/
https://www.ncbi.nlm.nih.gov/pubmed/28203093
http://dx.doi.org/10.2147/OTT.S103864
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author Alakel, Nael
Middeke, Jan Moritz
Schetelig, Johannes
Bornhäuser, Martin
author_facet Alakel, Nael
Middeke, Jan Moritz
Schetelig, Johannes
Bornhäuser, Martin
author_sort Alakel, Nael
collection PubMed
description Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs in oncologic and hematologic patients with large tumor burden, either due to cytotoxic therapy or, less commonly, spontaneously because of massive tumor cell lysis. TLS is clinically characterized by acute renal failure, hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. While limited options are available for treating TLS, identifying patients at high risk for developing TLS and prevention in high-risk patients remain an important aspect in the treatment of cancer patients. In general, treatment of TLS consists of intensive hydration, stimulation of diuresis, and, more specifically, in the use of allopurinol and rasburicase. Rasburicase, a recombinant urate oxidase, rapidly and effectively reduces hyperuricemia, which subsequently significantly decreases the risk of acute renal failure and other clinical manifestations of TLS. For this review, a comprehensive literature search using the term “tumor lysis syndrome” and/or “rasburicase” was performed considering articles listed in MEDLINE. Incidence, prevention, and therapy of TLS with a special focus on the role of rasburicase are discussed. We evaluated 120 relevant articles including 35 case reports, 32 clinical trials, and 14 meta-analyses.
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spelling pubmed-52958042017-02-15 Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase Alakel, Nael Middeke, Jan Moritz Schetelig, Johannes Bornhäuser, Martin Onco Targets Ther Review Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs in oncologic and hematologic patients with large tumor burden, either due to cytotoxic therapy or, less commonly, spontaneously because of massive tumor cell lysis. TLS is clinically characterized by acute renal failure, hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. While limited options are available for treating TLS, identifying patients at high risk for developing TLS and prevention in high-risk patients remain an important aspect in the treatment of cancer patients. In general, treatment of TLS consists of intensive hydration, stimulation of diuresis, and, more specifically, in the use of allopurinol and rasburicase. Rasburicase, a recombinant urate oxidase, rapidly and effectively reduces hyperuricemia, which subsequently significantly decreases the risk of acute renal failure and other clinical manifestations of TLS. For this review, a comprehensive literature search using the term “tumor lysis syndrome” and/or “rasburicase” was performed considering articles listed in MEDLINE. Incidence, prevention, and therapy of TLS with a special focus on the role of rasburicase are discussed. We evaluated 120 relevant articles including 35 case reports, 32 clinical trials, and 14 meta-analyses. Dove Medical Press 2017-02-02 /pmc/articles/PMC5295804/ /pubmed/28203093 http://dx.doi.org/10.2147/OTT.S103864 Text en © 2017 Alakel et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Alakel, Nael
Middeke, Jan Moritz
Schetelig, Johannes
Bornhäuser, Martin
Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase
title Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase
title_full Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase
title_fullStr Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase
title_full_unstemmed Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase
title_short Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase
title_sort prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295804/
https://www.ncbi.nlm.nih.gov/pubmed/28203093
http://dx.doi.org/10.2147/OTT.S103864
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