PGY-2 Oncology Pharmacy Resident Baptist Cancer Center Southaven, Mississippi, United States
Poster Abstract:
Background: Rasburicase is a recombinant urate-oxidase enzyme used for the treatment of tumor lysis syndrome (TLS). To prevent TLS in intermediate- or high-risk patients, allopurinol is the prescribed standard-of-care treatment; however, patients may have various risk factors elevating the TLS risk or occurrence. To mediate these additional risk factors, prescribers of one study have found using one-time lower doses of rasburicase for TLS prevention have often prevented the manifestations of the full condition. Another study found in 10 patients who were given rasburicase prophylactically that only 1 person experienced clinical TLS. Within various hematologic guidelines world-wide, many of them support the use of rasburicase for high-risk patients and recommend single lower doses (3 mg vs 0.1 mg/kg) for TLS prevention. While this is an off-label use, we hope to add to the literature our practices for using rasburicase in TLS prevention by assessing our institution’s prescribing patterns, evaluating patient characteristics or risk factors, and identifying areas for improvement within our hospital protocol.
Objectives: To assess patient criteria associated with rasburicase use, determine our annual use/cost of rasburicase, and to update our rasburicase protocol to match other recent literature recommendations
Methods: This study is a retrospective multi-center chart review of patients who received rasburicase from the Baptist Cancer Center oncologists.
Results: This section is pending per data analysis. Discussion/conclusions: This section is pending per data analysis.
References (must also be included in final poster): Vadhan-Raj S, Fayad LE, Fanale MA, Pro B, Rodriguez A, Hagemeister FB, Bueso-Ramos CE, Zhou X, McLaughlin PW, Fowler N, Shah J, Orlowski RZ, Samaniego F, Wang M, Cortes JE, Younes A, Kwak LW, Sarlis NJ, Romaguera JE. A randomized trial of a single-dose rasburicase versus five-daily doses in patients at risk for tumor lysis syndrome. Ann Oncol. 2012 Jun;23(6):1640-5. doi: 10.1093/annonc/mdr490. Epub 2011 Oct 19. PMID: 22015451; PMCID: PMC4110463.
McKenna S, Cheung A, Wolfe A, Coleman BL, Detsky ME, Munshi L, Maze D, Burry L. Clinical Interventions to Prevent Tumour Lysis Syndrome in Hematologic Malignancy: A Multisite Retrospective Chart Review. Can J Hosp Pharm. 2019 Nov-Dec;72(6):435-445. Epub 2019 Dec 1. PMID: 31853144; PMCID: PMC6910844.
Coiffier B, Altman A, Pui CH, Younes A, Cairo MS. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review [published correction appears in J Clin Oncol. 2010 Feb 1;28(4):708]. J Clin Oncol. 2008;26(16):2767-2778. doi:10.1200/JCO.2007.15.0177.
Jones GL, Will A, Jackson GH, Webb NJ, Rule S; British Committee for Standards in Haematology. Guidelines for the management of tumour lysis syndrome in adults and children with haematological malignancies on behalf of the British Committee for Standards in Haematology. Br J Haematol. 2015;169(5):661-671. doi:10.1111/bjh.13403.
