성인 악성 종양 환자의 고뇨산혈증에 대한 Rasburicase 효능 분석
Efficacy of Rasburicase on Hyperuricemia in Adult Patients with Malignant Tumor
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Rasburicase reduces uric acid levels by converting uric acid to allantoin. Allopurinol isthe most used in TLS(tumor lysis syndrome). However, it has limitations such as slow onset and kidneytoxicity. In Korea, a few research studies on rasburicase have been performed on pediatricpatients under 18 years. However, efficacy study of rasburicase in adult patients is limited. In thisstudy, we determined the efficacy of rasburicase on hyperuricemia in adult patients with malignanttumor and analyzed the factors that might have affected its ability to convert uric acid. From November 2006 to July 2012, a retrospective study was designed to analyze laboratorychanges of patients administrated 0.2 mg/kg rasburicase in Seoul National University Hospital whohad malignant tumor over the age of 18. A total of 21 patients was included. This study observed uricacid, creatinine, blood urea nitrogen etc. until 96 hours after the first administration of rasburicase. After 12 hours, uric acid levels of all patients were significantly (p<0.05) decreased. Average uricacid levels were decreased from 10.69±4.07 mg/dL to 1.94±3.13 mg/dL and maintained until 96hours post the first administration of rasburicase. Regression analysis revealed that lower percentageof reduced degree of 96 hours-uric acid was associated with higher numbers of white blood cells(WBC) and higher plasma uric acid levels before administration. In conclusion, rasburicase reduced uric acid levels in Korean adult patients effectively. Therefore, acareful monitoring will be required for patients who have high white blood cells or uric acid levelsbecause higher WBC and higher plasma uric acid levels before administration was associated withlower reduction of uric acid.
Abstract
Rasburicase reduces uric acid levels by converting uric acid to allantoin. Allopurinol isthe most used in TLS(tumor lysis syndrome). However, it has limitations such as slow onset and kidneytoxicity. In Korea, a few research studies on rasburicase have been performed on pediatricpatients under 18 years. However, efficacy study of rasburicase in adult patients is limited. In thisstudy, we determined the efficacy of rasburicase on hyperuricemia in adult patients with malignanttumor and analyzed the factors that might have affected its ability to convert uric acid. From November 2006 to July 2012, a retrospective study was designed to analyze laboratorychanges of patients administrated 0.2 mg/kg rasburicase in Seoul National University Hospital whohad malignant tumor over the age of 18. A total of 21 patients was included. This study observed uricacid, creatinine, blood urea nitrogen etc. until 96 hours after the first administration of rasburicase. After 12 hours, uric acid levels of all patients were significantly (p<0.05) decreased. Average uricacid levels were decreased from 10.69±4.07 mg/dL to 1.94±3.13 mg/dL and maintained until 96hours post the first administration of rasburicase. Regression analysis revealed that lower percentageof reduced degree of 96 hours-uric acid was associated with higher numbers of white blood cells(WBC) and higher plasma uric acid levels before administration. In conclusion, rasburicase reduced uric acid levels in Korean adult patients effectively. Therefore, acareful monitoring will be required for patients who have high white blood cells or uric acid levelsbecause higher WBC and higher plasma uric acid levels before administration was associated withlower reduction of uric acid.
참고문헌 (14)
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